Use of Citrated Whole Blood for Point-of-Care Viscoelastic Coagulation Testing in Dogs

Abstract

BackgroundA new, portable bedside coagulation monitor (VCM Vet) has provided a user-friendly, cartridge-based method to perform viscoelastic testing. However, the use of native whole blood limits the time to analyze the sample to minutes. The objective of this study is to assess whether citrated whole blood can be utilized with the cartridge-based system and whether the results are comparable to those of native whole blood. A secondary objective is to assess the viability of citrated whole blood results after up to 4 hours of resting.MethodsThe study population consisted of 10 healthy mixed breed dogs. Whole blood samples were collected via jugular venipuncture. Blood was immediately transferred to the VCM test cartridge for native whole blood control group analysis per the manufacturer's instructions, and the remainder was used to fill two 3.2% sodium citrate vacutainer tubes. Test group analysis was performed on samples from each tube concurrently after a rest period of 30 min (baseline), 2 h, and 4 h. Citrated whole blood samples were recalcified for analysis immediately prior to introduction into the test cartridge. Data was recorded for all reported parameters. Results from the citrate groups were compared to the control group and to the citrated baseline to assess for differences. Overall results were compared using mixed ANOVA models. Where found, specific differences were evaluated using Tukey's test. Within-sample variation was investigated and reported as median (range). A p < 0.05 was considered significant.ResultsSamples were obtained for a total of 10 control runs and 20 citrated whole blood runs. Comparison of controls to the citrated test groups revealed significant differences in CT (p < 0.001) and MCF (p < 0.002). There were no significant differences between test groups compared to citrated baselines for any parameter. Selected median coefficients of variation were 6.8% (0–68.8%) for CT, 2.4% (0–19.46%) for alpha angle, 3.2% (0–27.4%) for MCF, and 0% (0–16.3%) for 45-min LY45.ConclusionCitrated whole blood samples can be used with the VCM Vet device; however, new reference intervals for use with citrated whole blood will be required. Results using citrated whole blood samples are not significantly different from baseline after up to 4 h of resting.