PB0476 - Total Thrombus Formation Analysis System (T-TAS) Detects Poor Clot Formation in a Swine Model of Polytrauma and Hemorrhagic Shock

Monday, July 11, 2022

6:30 PM – 7:30 PM

Location: Exhibition

Presentation Format: In-Person

Presenting Author(s)

Alexis Cralley, MD

Research Fellow
University of Colorado
Aurora, Colorado, United States

Co-Author(s)

EM

Ernest E Moore, MD

Director of Research
Ernest E Moore Shock Trauma Center atDenver Health
Denver, Colorado, United States
Margot DeBot, MD

Surgery Resident
University of Colorado
Denver, Colorado, United States
Terry R. Schaid, Jr., MD

Surgery Resident
University of Colorado
Denver, Colorado, United States
CF

Charles Fox

Surgeon
University of Maryland
Baltimore, Maryland, United States
AG

Arsen Ghasabyan

Researcher
University of Colorado
Denver, Colorado, United States
SM

Sanchayita Mitra

Senior Researcher
University of Colorado, Department of Surgery
Aurora, Colorado, United States
PH

Patrick Hom

Researcher
University of Colorado
Denver, Colorado, United States
KH

Kirk Hansen

Professor
Department of Biochemistry and Molecular Genetics, University of Colorado Anschutz Medical Campus
Aurora, Colorado, United States
MC

Mitchell J Cohen

Surgeon
University of Colorado
Aurora, Colorado, United States
CS

Christopher Silliman

Professor
University of Colorado
Aurora, Colorado, United States
AS

Angela Sauaia

Professor
University of Colorado
Aurora, Colorado, United States

Background: T-TAS has gained popularity as a diagnostic tool to monitor antiplatelet therapy and predict bleeding risks. Its applicability to monitor trauma induced coagulopathy has not yet been assessed. The T-TAS AR chip evaluates fibrin-rich thrombus progression during arterial shear stress using platelet and coagulation system interactions. We hypothesized that the T-TAS AR Chip measurements (T10, OT, and AUC30) would correlate with prothrombin time (PT) and thrombelastography (TEG) measurements in detecting coagulopathy.

Aims: Using PT and TEG as gold standards, we evaluated the diagnostic accuracy of T-TAS.

Methods: 16 Yorkshire swine were randomized to undergo either instrumentation only (SHAM), or an injury model (INJURY: blast brain injury, femur fractures, hemorrhagic shock) followed by resuscitation. Native TEG, PT, and T-TAS measurements were performed in tandem on citrated blood samples collected at baseline, and at 60 and 240 minutes post-injury. Coagulopathy was defined as PT>14sec ( >2 SD above baseline mean). Correlation of T-TAS values with TEG and PT findings were conducted using Pearson’s correlation test.

Results: 4 Swine were assigned to the SHAM group and 12 to the INJURY group. The INJURY group developed coagulopathy at 60min (PT=15.4±3.8sec) and 240min (PT=14.91±2.2sec), while the SHAM group did not develop any coagulopathy. At baseline, the T-TAS outcome T10 correlated strongly with TEG’s R-Time (R=0.7, p=0.002) and Angle (R=-0.67, p=0.005), and correlated weakly with PT (R=0.35. p=0.18). R-time remained highly correlated with T10 throughout the experiment for both groups. PT and Angle showed correlations with T-TAS measurements at maximum coagulopathy in the INJURY group at 60min. MA was not significantly correlated to any T-TAS measurements.

Conclusion(s): T-TAS T10 appears to be a sensitive marker for detecting hypocoagulability postinjury, with strong correlations to the TEG R-Time. Other T-TAS measurements only correlated with PT and Angle during PT-detected hypocoagulability.