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Evaluation of fibrinogen concentration by clot firmness using a dielectric blood coagulation test system

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Abstract

Purpose

To determine if fibrinogen concentration can be evaluated by dielectric permittivity changes in dielectric blood coagulation testing (DBCM) during cardiovascular surgery with cardiopulmonary bypass (CPB).

Methods

We performed a single-center prospective observational study at a university hospital. One hundred patients undergoing cardiovascular surgery with CPB were enrolled. Whole-blood samples were obtained after weaning from CPB, and dielectric clot strength (DCS) was measured by intrinsic pathway testing with or without heparinase in DBCM. The FIBTEM test was performed during rotational thromboelastometry using the same samples, and maximum clot firmness (MCF) was evaluated. Spearman’s correlation analysis was performed, and receiver operating characteristics (ROC) curve analyses were used to evaluate the performance of hypofibrinogenemia detection.

Results

DCS showed a strong positive correlation with plasma fibrinogen concentration (Rs = 0.76, P < 0.0001). The area under the ROC curve for evaluating plasma fibrinogen concentration < 200 mg/dL was 0.91 (95% confidence interval (CI) 0.85–0.97) for DCS, compared with 0.88 (95% CI 0.81–0.94) for FIBTEM MCF. The optimal cutoff value of DCS was 17.0 (sensitivity 94%, specificity 80%).

Conclusions

DCS variables showed a significantly strong correlation with plasma fibrinogen concentration, and the diagnostic performance for hypofibrinogenemia was comparable to that for FIBTEM MCF. This novel methodology has the potential to provide a point-of-care test with sufficient accuracy for the detection of perioperative hypofibrinogenemia during cardiovascular surgery with CPB.

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Acknowledgements

We thank Susan Furness, PhD, and H. Nikki March, PhD, from Edanz (https://www.jp.edanz.com/ac) for editing a draft of this manuscript.

Funding

This work was supported by the Cooperation Program between Tokyo Medical and Dental University (TMDU) and Sony IP&S, Inc. Sony IP&S had no influence on the data collection or analysis of the results.

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Author notes

  1. Yoshihito Hayashi

    Present address: Tokyo Laboratory 11, R&D Center, Sony Group Corporation, Bunkyo-Ku, Tokyo, 113-8519, Japan

  2. Yulin Zeng and Yudai Yamamoto contributed equally to this study.

Authors and Affiliations

  1. Department of Anesthesiology, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University, 1-5-45 Yushima, Bunkyo-Ku, Tokyo, 113-8519, Japan

    Yulin Zeng, Yudai Yamamoto & Tokujiro Uchida

  2. Biomedical R&D Department, R&D Division, Medical Business Group, Sony Imaging Products & Solutions Inc., Bunkyo-Ku, Tokyo, 113-8519, Japan

    Yoshihito Hayashi

Authors
  1. Yulin Zeng
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  4. Tokujiro Uchida
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Contributions

All authors contributed to the study conception and design. Material preparation, data collection, and analysis were performed by YZ, YY and TU. YH supported the technological instruction of the prototype device and contributed to the explanation of the methodology in this manuscript. The first draft of the manuscript was written by YZ and TU. All authors commented on drafts of the manuscript. All authors read and approved the final version of the manuscript.

Corresponding author

Correspondence to Tokujiro Uchida.

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Conflict of interest

TU was supported by the Cooperation Program between Tokyo Medical and Dental University (TMDU) and Sony IP&S, Inc. TU declares this study was funded by this cooperation program. YH was an employee of Sony IP&S, Inc., and now an employee of Sony Group Corporation. YH supported the technological instruction of the prototype device and contributed to the explanation of the methodology in this manuscript. YZ and YY have no conflicts of interest directly relevant to the content of this article.

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Zeng, Y., Yamamoto, Y., Hayashi, Y. et al. Evaluation of fibrinogen concentration by clot firmness using a dielectric blood coagulation test system. J Anesth 37, 56–63 (2023). https://doi.org/10.1007/s00540-022-03131-x

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  • DOI: https://doi.org/10.1007/s00540-022-03131-x

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