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Comparison of functional fibrinogen (FF/CFF) and FIBTEM in surgical patients – a retrospective study

  • Florian Prüller EMAIL logo , Andreas Münch , Astrid Preininger , Reinhard Bernd Raggam , Yvonne Grinschgl , Jakub Krumnikl , Wolfgang Toller , Hellfried Metzler , Elisabeth Mahla and Harald Mangge EMAIL logo
Published/Copyright: August 19, 2015
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Clinical Chemistry and Laboratory Medicine (CCLM)
From the journal Clinical Chemistry and Laboratory Medicine (CCLM) Volume 54 Issue 3

Abstract

Background: Fibrinogen-based clot firmness is reported as the maximum amplitude (MA) when using the citrated functional fibrinogen (CFF) assay in thrombelastography (TEG), and as the maximum clot firmness (MCF) together with several clot amplitude parameters when using the FIBTEM assay in thromboelastometry (ROTEM). Concern is currently being raised that these two tests have different platelet inhibiting performance and consequently provide different values. This is relevant for the clinical setting of fibrinogen replacement. We aim herein to compare the parameters of these two fibrinogen-based clot quality tests and their correlation with the plasma fibrinogen level as determined by the Clauss method.

Methods: In total 261 whole blood samples taken from 163 clinical routine surgical patients were analyzed with TEG 5000 and ROTEM tests, and correlation with Clauss fibrinogen level was assessed.

Results: Using TEG, the overall fibrin-based clot firmness measured in the CFF assay was significantly higher than the MCF measured by FIBTEM assay. Both assays showed significantly positive correlations with the fibrinogen levels measured using the Clauss method. However, individual values of Clauss fibrinogen concentration corresponded with different values for the two viscoelastometric tests; e.g. within the range of 1.9–2.1 g/L Clauss fibrinogen the median of CFF MA was 16.3 mm whereas FIBTEM MCF was 12.0 mm.

Conclusions: We showed herein by measurements of citrated whole blood samples from surgical patients that CFF MA values were different from FIBTEM MCF values measured in the same sample. Awareness that these whole blood assays provide different clot amplitude results is mandatory, particularly if they are being considered as tools for guiding fibrinogen supplementation. Thromboembolic side effects caused by a potentially too high fibrinogen substitution must also kept in mind in this context.

Keywords: Clauss; comparison of methods; fibrinogen; fibrinogen replacement therapy; thrombelastography; thrombelastometry; thromboelastometry
Corresponding authors: Dr. Florian Prüller, MD, Clinical Institute of Medical and Chemical Laboratory Diagnostics, Medical University of Graz, Auenbruggerplatz 15, 8036 Graz, Austria, Phone: +43 316 385 82576 and 83340, Fax: +43 316 385 14024, E-mail: ; and Research Unit “Perioperative Platelet Function”, Medical University of Graz, Graz, Austria; and Prof. Dr. Harald Mangge, MD, Clinical Institute of Medical and Chemical Laboratory Diagnostics, Medical University of Graz, Auenbruggerplatz 15, 8036 Graz, Austria, Phone: +43 316 385 82576 and 83340, Fax: +43 316 385 14024, E-mail: ; and BioTechMed-Graz, Graz, Austria

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Received: 2015-4-13
Accepted: 2015-7-15
Published Online: 2015-8-19
Published in Print: 2016-3-1

©2016 by De Gruyter

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https://doi.org/10.1515/cclm-2015-0345
Keywords for this article
Clauss; comparison of methods; fibrinogen; fibrinogen replacement therapy; thrombelastography; thrombelastometry; thromboelastometry

Articles in the same Issue

  1. Frontmatter
  2. Editorial
  3. The way of prostate cancer diagnostics
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  7. The side effects of translational omics: overtesting, overdiagnosis, overtreatment
  8. Genetics and Molecular Diagnostics
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  10. General Clinical Chemistry and Laboratory Medicine
  11. Patient pools and the use of “patient means” are valuable tools in quality control illustrated by a bone-specific alkaline phosphatase assay
  12. Long-term stability of glucose: 96-h study using Terumo Glycaemia tubes
  13. Glucose is stable during prolonged storage in un-centrifuged Greiner tubes with liquid citrate buffer, but not in serum and NaF/KOx tubes
  14. Croatian laboratories have a good knowledge of the proper detection and management of hemolyzed, icteric and lipemic samples
  15. Fetal exposure to ethanol: relationship between ethyl glucuronide in maternal hair during pregnancy and ethyl glucuronide in neonatal meconium
  16. Comparing the effect of isotopically labeled or structural analog internal standards on the performance of a LC-MS/MS method to determine ciclosporin A, everolimus, sirolimus and tacrolimus in whole blood
  17. Relationship between matrix metalloproteinase-9 and oxidative stress in drug-free male schizophrenia: a case control study
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