Managing Coagulation Using the Sonoclot Analyzer in Patients With Disseminated Intravascular Coagulation.

IF 2.7 3区医学 Q2 CRITICAL CARE MEDICINE

American Journal of Critical Care Pub Date : 2025-05-01 DOI:10.4037/ajcc2025807

Peng Wan, Yan Geng, Lei Su, Jinghua Liu, Huasheng Tong, Zhifeng Liu, Wenda Chen, Baojun Yu, Na Peng

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引用次数: 0

Abstract

Background: Evidence for the effectiveness of the Sonoclot analyzer in improving clinical outcomes in disseminated intravascular coagulation (DIC) is lacking.

Objective: To evaluate the effectiveness of an algorithm based on the Sonoclot analyzer in improving the short-term prognosis of patients with DIC.

Methods: A total of 279 patients with overt DIC who were admitted to the hospital within 18 months before and after implementation of the new Sonoclot-based algorithm were enrolled in the study. They were assigned to either a conventional coagulation assay (CCA) group (n = 148) or a Sonoclot group (n = 131). Data associated with anti-coagulation and transfusion were collected and analyzed. The 30-day survival rate after hospital admission was compared between groups.

Results: The Sonoclot group had a higher 30-day survival rate than the CCA group (78.45% vs 63.64%; P = .02). The heparin dose, anticoagulation course, and major bleeding rate were significantly reduced in the Sonoclot group compared with the CCA group for all patients and for patients undergoing continuous renal replacement therapy (all P < .001). Fresh frozen plasma, platelet, and cryoprecipitate requirements were substantially lower in the Sonoclot group than in the CCA group (P = .007, .03, and .02, respectively). In a stratified analysis, improved survival rate was seen mainly in patients with moderately severe sepsis and heatstroke, with an Acute Physiology and Chronic Health Evaluation II score of 20 to 29.

Conclusion: The Sonoclot analyzer may be useful to guide coagulation management in patients with DIC. Use of the Sonoclot-based algorithm may improve outcomes for DIC patients with moderately severe sepsis or heatstroke.

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在弥漫性血管内凝血患者中应用超声分析仪管理凝血。

背景：Sonoclot分析仪在改善弥散性血管内凝血（DIC）临床结果方面的有效性尚缺乏证据。目的：评价一种基于Sonoclot分析仪的算法对改善DIC患者短期预后的有效性。方法：共有279例公开性DIC患者在实施新的基于超声心动图的算法前后18个月内入院。他们被分为常规凝血试验（CCA）组（n = 148）和Sonoclot组（n = 131）。收集并分析抗凝和输血相关数据。比较两组患者入院后30天生存率。结果：Sonoclot组30天生存率高于CCA组(78.45% vs 63.64%；P = .02)。与CCA组相比，Sonoclot组所有患者和接受持续肾脏替代治疗的患者的肝素剂量、抗凝疗程和大出血率均显著降低（P < 0.001）。Sonoclot组的新鲜冷冻血浆、血小板和低温沉淀需要量明显低于CCA组（P值分别为0.07、0.03和0.02）。在一项分层分析中，生存率的提高主要出现在中重度脓毒症和中暑患者中，急性生理和慢性健康评估II评分为20至29分。结论：超声分析仪可指导DIC患者的凝血管理。使用基于超声心动图的算法可以改善DIC合并中重度脓毒症或中暑患者的预后。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

American Journal of Critical Care 医学-护理

CiteScore

4.30

自引率

3.70%

发文量

103

审稿时长

6-12 weeks

期刊介绍： The editors of the American Journal of Critical Care (AJCC) invite authors to submit original manuscripts describing investigations, advances, or observations from all specialties related to the care of critically and acutely ill patients. Papers promoting collaborative practice and research are encouraged. Manuscripts will be considered on the understanding that they have not been published elsewhere and have been submitted solely to AJCC.