Sonoclot advanced coagulation and platelet function analyzer (Sonoclot analyzer) has been widely used in clinical practice since it was invented in 1975 by Von Kaulla. Working principle of vibrating up and down in blood specimens (0.4 ml) tubular probe with bleeding at all stages of change the movement of the resistance encountered by an analog electrical signals in Sonoclot analyzer, and then report to come out in the form of blood coagulation signal. Sonoclot coagulation apparatus has been used in the clinical course to reflect accurate and rapid characteristics, which has been helpful to guide clinical treatment.
1 help clinical identification of high coagulation state
A Sonoclot analysis was performed more than 30 years ago using Sonoclot analysis to find that the patients with high coagulation state after liver transplantation were up to 64%~ 79%, and the detection rate could reach 79%~100% if combined with the fiber protease production test (TGT). The application prospect of sonoclot coagulometer in clinic is described. Francis and other applications of Sonoclot analyzer found that patients with malignant tumors had high blood clotting tendency. Pivallizza [1] using the same methods, such as one after another to study the perioperative uremia patients of blood coagulation state and obese patients, the results show that the two types of patients have high blood coagulation state, and uremic patients have obvious fibrinolysis slowed (p < 0.05). It is suggested that such patients should be at risk of thrombosis. Kohro et al. found that intermittent inflating device can activate fibrinolysis without changing the coagulation of blood and platelet activity. Liszka et al. found that the viscoelastic graph obtained by Sonoclot can be found in patients with coagulation disorders such as Hellp Syndrome. It can be seen that sonoclot coagulation analyzer can effectively detect the high coagulation state of patients and guide clinical guidance.
2. Monitoring the effect of drug on coagulation function
Clinically, many drugs can affect the blood coagulation function of patients, such as aspirin, Chinese law, low molecular weight heparin, and shep, etc. Many people are trying to use the sonoclot coagulator to monitor blood clotting during medication. The study of patients with CPB after the use of the Sonoclot analyzer, such as Stern and Samra, showed that taking aspirin after CPB was not associated with increased bleeding. Schott [2] to total pulp replacement application of desmopressin acetate increased patient blood coagulation function is studied, found desmopressin acetate does not reduce total pulp replacement patients' blood loss. Zimmer et al. [3] found that puvastatin could strengthen the effect of low molecular heparin on coagulation. Tanaka et al. [4] found that tirofiban caused platelet activation delays to affect the production of thrombin and prolongs the ACT of heparin blood. Actually, for clinical use affect patients' blood coagulation function best when drug monitoring, sonoclot blood coagulation analyzer coagulant function abnormality can be found in a timely manner, to reasonable and safe application.
3. Bleeding tendency and guidance treatment
The lack of coagulation factor, the decrease of platelet number, the function of platelet function, the hyperfibrinolysis, etc., can lead to clinical bleeding tendency. The Sonoclot analyzer can identify the causes of bleeding and help guide the treatment through the analysis of the whole process of the hemostatic system. The Sonoclot analyzer predicted 74% of postoperative bleeding and only 33% of conventional coagulation tests. Chapin et al. found that Sonoclot analyzer was suitable for monitoring the changes of platelet function and coagulation factor in liver transplantation. Miyashita et al. [5] believed that the TP on the Sonoclot marker curve was mainly related to platelet count, platelet function, fibrinogen level and CPB time, while R1 was only related to fibrinogen. CPB also has a major impact on platelet count and aggregation function [6]. Kamada et al. [7] recommend Sonoclot coagulation as a method to evaluate the dissolution of fibrinolytic protein after cardiac surgery. Furuhashi et al. [8] believed that Sonoclot could well monitor the coagulation state of patients with bedside blood filtration, which could regulate the dosage of heparin. Schott etc. [9] report a case of meningococcal sepsis patients with severe DIC, through the combination of RCT Sonoclot monitoring use of blood products for successful, explain Sonoclot than traditional blood coagulation analyzer examination can be more quick, convenient and accurate to provide blood coagulation process for more information, help guide treatment.
The effect of liquid recovery on coagulation function
Whether the recovery liquid has an effect on coagulation function has many clinicians concerned. Konrad et al. [10, 11] used Sonoclot analysis to find out that the ringer fluid had the tendency to enhance the coagulation function. Gelatine had the minimal effect on coagulation function, and hydroxyethyl starch had the greatest influence. Coats [12], such as using Sonoclot influence on blood coagulation analyzer found recovery liquid is complicated, it is not only the difference between crystal and colloid, and with what kind of crystal is specific or colloid, and the liquid level of blood dilution. They [13] also found that calcium ions did not interfere with the effects of blood stator and seguin on coagulation.
The effect of body temperature on coagulation function
Shimokawa et al. [14] animal experiments showed that Sonoclot can detect the decline of coagulation falls and thrombocytopenia during hypothermia. And traditional detection at 37 ℃, so difficult to really reflect the patient's body in low temperature state of blood coagulation. Pivalizza etc. [15] found general high fever (41 ℃) fibrinogen agglutination rate was accelerated.
6 conclusion
Sonoclot analyzer can be widely used in clinical monitoring of coagulation and platelet function, indicating bleeding tendency and guiding clinical treatment. However, as with any other laboratory examination, the results of the Sonoclot analyzer should not be the only basis for diagnosis, and must be considered in combination with the patient's specific condition and other test results.
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