{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,1,18]],"date-time":"2026-01-18T06:56:57Z","timestamp":1768719417195,"version":"3.49.0"},"reference-count":32,"publisher":"Oxford University Press (OUP)","issue":"5-6","license":[{"start":{"date-parts":[[2024,9,12]],"date-time":"2024-09-12T00:00:00Z","timestamp":1726099200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/academic.oup.com\/journals\/pages\/open_access\/funder_policies\/chorus\/standard_publication_model"}],"funder":[{"DOI":"10.13039\/100000090","name":"Congressionally Directed Medical Research Programs","doi-asserted-by":"publisher","award":["W81XWH1920008"],"award-info":[{"award-number":["W81XWH1920008"]}],"id":[{"id":"10.13039\/100000090","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100000090","name":"Congressionally Directed Medical Research Programs","doi-asserted-by":"publisher","award":["W81XWH1920008"],"award-info":[{"award-number":["W81XWH1920008"]}],"id":[{"id":"10.13039\/100000090","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2025,4,23]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n               <jats:sec>\n                  <jats:title>Introduction<\/jats:title>\n                  <jats:p>Absence of pre-hospital coagulation tests challenges prompt management of hemostasis after trauma. The Viscoelastic Coagulation Monitor (VCM, Entegrion, Durham, NC) is a hand-held coagulation test for point-of-care. We evaluated VCM in a translational swine polytrauma model, hypothesizing that VCM correlates with a laboratory reference method, the TEG 5000 (Haemonetics, Boston, MA), and can identify coagulopathic phenotypes relevant to trauma. Our secondary hypothesis was that pre-warming of VCM disposable test cartridges using a heating plate versus pre-warming of cartridges by carrying the cartridge in the user\u2019s pocket does not significantly alter results.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Materials and Methods<\/jats:title>\n                  <jats:p>This study was conducted in tandem with a parent study involving anesthetized, mechanically ventilated swine (n\u2009=\u200920; 54\u2009\u00b1\u20095\u2009kg) that encountered traumatic brain injury, pulmonary contusion and hemorrhage, or combination\/polytrauma injury. Blood was collected at baseline, post-injury, post-shock, post-transfusion, and 6-, 24-, and 48\u2009h post-injury to perform VCM at point-of-care. Within-group effect of time was assessed. Spearman correlation examined linear relations between VCM and standard laboratory-based coagulation tests; as well as lactate, ionized calcium, and body temperature. Logistic regression examined predictiveness of VCM to identify coagulopathic phenotypes, with receiver operator characteristic curves generated to assess diagnostic capability. At a subset of timepoints, necessity of pre-warming the VCM test cartridge using a heating plate versus pre-warming the cartridge by placement in the user\u2019s pocket was assessed by conducting simultaneous tests on two separate instruments, with results analyzed by paired t-test with crossover design.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Results<\/jats:title>\n                  <jats:p>VCM revealed time-dependent changes in clotting time, clot formation time (CFT), alpha, maximum clot firmness (MCF), and lysis index (LI30). All VCM metrics correlated with the respective TEG 5000 metrics, with strongest correlation for VCM MCF with TEG MA (rhos\u2009=\u20090.77, P\u2009&amp;lt;\u2009.0001) and VCM LI30 with TEG LY30 (rhos\u2009=\u2009\u22120.76, P\u2009&amp;lt;\u2009.0001). VCM demonstrated good (area under the curve\u2009&amp;gt;0.70) to excellent (area under the curve\u2009&amp;gt;0.90) diagnostic accuracy in detection of low platelet count (MCF), low hematocrit (clotting time, clot formation time, alpha, and MCF), low fibrinogen (MCF), and high fibrinogen (alpha, MCF). There was no statistically or clinically relevant effect of cartridge warming method on results.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Conclusions<\/jats:title>\n                  <jats:p>In a trauma model, VCM detected significant changes in coagulation at point-of-care in a simplified portable form factor. VCM could enable informed hemostasis management in pre-hospital settings where coagulations tests are unavailable, pending further validation in clinical trials.<\/jats:p>\n               <\/jats:sec>","DOI":"10.1093\/milmed\/usae430","type":"journal-article","created":{"date-parts":[[2024,9,13]],"date-time":"2024-09-13T21:50:00Z","timestamp":1726264200000},"page":"e994-e1003","source":"Crossref","is-referenced-by-count":2,"title":["A Deployable Viscoelastic Coagulation Monitor Enables Point-of-Care Assessment of Coagulopathy in Swine With Polytrauma"],"prefix":"10.1093","volume":"190","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-2460-6432","authenticated-orcid":false,"given":"Teryn R","family":"Roberts","sequence":"first","affiliation":[{"name":"Autonomous Reanimation and Evacuation Research Institute, The Geneva Foundation , San Antonio, TX 78235,","place":["USA"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Isabella","family":"Garcia","sequence":"additional","affiliation":[{"name":"Autonomous Reanimation and Evacuation Research Institute, The Geneva Foundation , San Antonio, TX 78235,","place":["USA"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ivan","family":"Slychko","sequence":"additional","affiliation":[{"name":"Shupyk National Healthcare University of Ukraine , Kyiv, 04112,","place":["Ukraine USA"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Heidi J","family":"Dalton","sequence":"additional","affiliation":[{"name":"Creighton University , Phoenix, AZ 85012,","place":["USA"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Andriy I","family":"Batchinsky","sequence":"additional","affiliation":[{"name":"Autonomous Reanimation and Evacuation Research Institute, The Geneva Foundation , San Antonio, TX 78235,","place":["USA"]}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"286","published-online":{"date-parts":[[2024,9,12]]},"reference":[{"issue":"6","key":"2025091815443695900_R1","doi-asserted-by":"crossref","first-page":"S3","DOI":"10.1097\/01.ta.0000199961.02677.19","article-title":"Impact of hemorrhage on trauma outcome: an overview of epidemiology, clinical presentations, and therapeutic considerations","volume":"60","author":"Kauvar","year":"2006","journal-title":"J Trauma Acute Care"},{"issue":"1","key":"2025091815443695900_R2","doi-asserted-by":"crossref","DOI":"10.1038\/s41572-021-00264-3","article-title":"Trauma-induced coagulopathy","volume":"7","author":"Moore","year":"2021","journal-title":"Nature Reviews Disease Primers"},{"issue":"1 Suppl","key":"2025091815443695900_R3","first-page":"S4","article-title":"Died of wounds on the battlefield: causation and implications for improving combat casualty care","volume":"71","author":"Eastridge","year":"2011","journal-title":"J Trauma"},{"issue":"S2","key":"2025091815443695900_R4","doi-asserted-by":"publisher","first-page":"1423","DOI":"10.1111\/trf.15161","article-title":"Outcomes of traumatic hemorrhagic shock and the epidemiology of preventable death from injury","volume":"59","author":"Eastridge","year":"2019","journal-title":"Transfusion"},{"issue":"6","key":"2025091815443695900_R5","doi-asserted-by":"publisher","DOI":"10.1097\/TA.0000000000000341","article-title":"Hyperfibrinolysis, physiologic fibrinolysis, and fibrinolysis shutdown: the spectrum of postinjury fibrinolysis and relevance to antifibrinolytic therapy","volume":"77","author":"Moore","year":"2014","journal-title":"J Trauma Acute Care Surg"},{"issue":"3","key":"2025091815443695900_R6","doi-asserted-by":"publisher","first-page":"225","DOI":"10.20408\/jti.2020.0074","article-title":"Major causes of preventable death in trauma patients","volume":"34","author":"Park","year":"2021","journal-title":"J Korean Soc Traumatol"},{"issue":"2","key":"2025091815443695900_R7","doi-asserted-by":"publisher","first-page":"246","DOI":"10.1097\/ACO.0000000000000836","article-title":"Point-of-care diagnostics of coagulation in the management of bleeding and transfusion in trauma patients","volume":"33","author":"Francis","year":"2020","journal-title":"Curr Opin Anaesthesiol"},{"issue":"4","key":"2025091815443695900_R8","doi-asserted-by":"publisher","first-page":"59","DOI":"10.55460\/6OJ3-UGS5","article-title":"Point-of-care coagulation testing for trauma patients in a military setting: a prospective study","volume":"13","author":"Cotte","year":"2013","journal-title":"J Spec Oper Med"},{"key":"2025091815443695900_R9","doi-asserted-by":"publisher","DOI":"10.1186\/s13049-015-0139-6","article-title":"Point of care coagulometry in prehospital emergency care: an observational study","volume":"23","author":"Beynon","year":"2015","journal-title":"Scand J Trauma Resusc Emerg Med"},{"issue":"3","key":"2025091815443695900_R10","doi-asserted-by":"publisher","first-page":"476","DOI":"10.1097\/SLA.0b013e3182658180","article-title":"Admission rapid thrombelastography can replace conventional coagulation tests in the emergency department: experience with 1974 consecutive trauma patients","volume":"256","author":"Holcomb","year":"2012","journal-title":"Ann Surg"},{"issue":"4","key":"2025091815443695900_R11","doi-asserted-by":"crossref","first-page":"716","DOI":"10.1097\/00005373-199704000-00023","article-title":"Usefulness of thrombelastography in assessment of trauma patient coagulation","volume":"42","author":"Kaufmann","year":"1997","journal-title":"J Trauma Acute Care"},{"issue":"2","key":"2025091815443695900_R12","doi-asserted-by":"publisher","DOI":"10.3390\/diagnostics10020118","article-title":"Viscoelastic hemostatic assays: moving from the laboratory to the site of care\u2014a review of established and emerging technologies","volume":"10","author":"Hartmann","year":"2020","journal-title":"Diagnostics"},{"issue":"6S Suppl 1","key":"2025091815443695900_R13","doi-asserted-by":"publisher","first-page":"S83","DOI":"10.1097\/TA.0000000000001810","article-title":"Functional stability of the TEG 6s hemostasis analyzer under stress","volume":"84","author":"Meledeo","year":"2018","journal-title":"J Trauma Acute Care Surg"},{"issue":"1S Suppl 1","key":"2025091815443695900_R14","doi-asserted-by":"publisher","first-page":"S119","DOI":"10.1097\/TA.0000000000002224","article-title":"Thromboelastography on-the-go: evaluation of the TEG 6s device during ground and high-altitude aeromedical evacuation with extracorporeal life support","volume":"87","author":"Roberts","year":"2019","journal-title":"J Trauma Acute Care Surg"},{"issue":"3","key":"2025091815443695900_R15","doi-asserted-by":"publisher","first-page":"254","DOI":"10.1097\/MAT.0000000000001380","article-title":"Viscoelastic coagulation monitor as a novel device to assess coagulation at the bedside. A single-center experience during the COVID-19 Pandemic","volume":"67","author":"Panigada","year":"2021","journal-title":"ASAIO J"},{"key":"2025091815443695900_R16","doi-asserted-by":"publisher","DOI":"10.3389\/fped.2022.910646","article-title":"Hemostatic evaluation with viscoelastic coagulation monitor: a NICU experience","volume":"10","author":"Amelio","year":"2022","journal-title":"Front Pediatr"},{"issue":"8","key":"2025091815443695900_R17","doi-asserted-by":"publisher","first-page":"1052","DOI":"10.1080\/09537104.2019.1704719","article-title":"Performance evaluation of a new point of care viscoelastic coagulation monitoring system in major abdominal, orthopaedic and vascular surgery","volume":"31","author":"Brearton","year":"2020","journal-title":"Platelets"},{"issue":"10","key":"2025091815443695900_R18","doi-asserted-by":"publisher","first-page":"2314","DOI":"10.1097\/CCM.0b013e318225b5b3","article-title":"Comparison of airway pressure release ventilation to conventional mechanical ventilation in the early management of smoke inhalation injury in swine","volume":"39","author":"Batchinsky","year":"2011","journal-title":"Crit Care Med"},{"issue":"3","key":"2025091815443695900_R19","doi-asserted-by":"publisher","first-page":"895","DOI":"10.1152\/japplphysiol.00563.2006","article-title":"Ventilation-perfusion relationships following experimental pulmonary contusion","volume":"103","author":"Batchinsky","year":"2007","journal-title":"J Appl Physiol (1985)"},{"issue":"7","key":"2025091815443695900_R20","doi-asserted-by":"publisher","first-page":"579","DOI":"10.1046\/j.1525-1594.2001.025007579.x","article-title":"Are standard human coagulation tests suitable in pigs and calves during extracorporeal circulation?","volume":"25","author":"Mueller","year":"2001","journal-title":"Artif Organs"},{"issue":"4","key":"2025091815443695900_R21","doi-asserted-by":"publisher","first-page":"419","DOI":"10.1097\/SHK.0b013e3181b8bcd9","article-title":"Dynamic changes in shunt and ventilation-perfusion mismatch following experimental pulmonary contusion","volume":"33","author":"Batchinsky","year":"2010","journal-title":"Shock"},{"issue":"7","key":"2025091815443695900_R22","doi-asserted-by":"publisher","first-page":"798","DOI":"10.1097\/MAT.0000000000001292","article-title":"Tethered liquid perfluorocarbon coating for 72 hour heparin-free extracorporeal life support","volume":"67","author":"Roberts","year":"2021","journal-title":"ASAIO J"},{"issue":"7","key":"2025091815443695900_R23","doi-asserted-by":"publisher","first-page":"809","DOI":"10.1097\/MAT.0000000000001055","article-title":"Heparin-free extracorporeal life support using tethered liquid perfluorocarbon: a feasibility and efficacy study","volume":"66","author":"Roberts","year":"2020","journal-title":"ASAIO J"},{"issue":"4","key":"2025091815443695900_R24","doi-asserted-by":"publisher","first-page":"923","DOI":"10.1002\/jbm.b.35202","article-title":"A dual-action nitric oxide-releasing slippery surface for extracorporeal organ support: dynamic in vitro hemocompatibility evaluation","volume":"111","author":"Roberts","year":"2023","journal-title":"J Biomed Mater Res Part B"},{"issue":"3","key":"2025091815443695900_R25","doi-asserted-by":"publisher","first-page":"91","DOI":"10.1016\/j.tjem.2018.08.001","article-title":"User\u2019s guide to correlation coefficients","volume":"18","author":"Akoglu","year":"2018","journal-title":"Turkish J Emerg Med"},{"issue":"1","key":"2025091815443695900_R26","doi-asserted-by":"publisher","first-page":"21","DOI":"10.30802\/AALAS-JAALAS-21-000014","article-title":"Biochemical and hematologic reference intervals for anesthetized, female, juvenile Yorkshire swine","volume":"61","author":"Dimitrakakis","year":"2022","journal-title":"J Am Assoc Lab Anim Sci"},{"issue":"5","key":"2025091815443695900_R27","doi-asserted-by":"publisher","first-page":"1091","DOI":"10.1097\/ALN.0000000000003165","article-title":"Comparison of neonatal and adult fibrin clot properties between porcine and human plasma","volume":"132","author":"Nellenbach","year":"2020","journal-title":"Anesthesiology"},{"issue":"9","key":"2025091815443695900_R28","doi-asserted-by":"publisher","first-page":"1315","DOI":"10.1097\/JTO.0b013e3181ec173d","article-title":"Receiver operating characteristic curve in diagnostic test assessment","volume":"5","author":"Mandrekar","year":"2010","journal-title":"J Thorac Oncol"},{"issue":"4","key":"2025091815443695900_R29","doi-asserted-by":"publisher","first-page":"660","DOI":"10.1111\/vcp.12916","article-title":"Establishment of a reference interval for a novel viscoelastic coagulometer and comparison with thromboelastography in healthy cats","volume":"49","author":"Rosati","year":"2020","journal-title":"Vet Clin Pathol\/Am Soc Vet Clin Pathol"},{"issue":"2","key":"2025091815443695900_R30","doi-asserted-by":"crossref","first-page":"287","DOI":"10.1097\/TA.0000000000001282","article-title":"Model of trauma-induced coagulopathy including hemodilution, fibrinolysis, acidosis, and hypothermia: impact on blood coagulation and platelet function","volume":"82","author":"Shenkman","year":"2017","journal-title":"J Trauma Acute Care"},{"issue":"5","key":"2025091815443695900_R31","doi-asserted-by":"publisher","first-page":"1002","DOI":"10.1097\/01.TA.0000156246.53383.9F","article-title":"Independent contributions of hypothermia and acidosis to coagulopathy in swine","volume":"58","author":"Martini","year":"2005","journal-title":"J Trauma Acute Care"},{"issue":"15","key":"2025091815443695900_R32","doi-asserted-by":"publisher","DOI":"10.3390\/s20154254","article-title":"Point-of-care diagnostics in coagulation management","volume":"20","author":"Sahli","year":"2020","journal-title":"Sensors"}],"container-title":["Military Medicine"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/academic.oup.com\/milmed\/article-pdf\/190\/5-6\/e994\/59105965\/usae430.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"syndication"},{"URL":"https:\/\/academic.oup.com\/milmed\/article-pdf\/190\/5-6\/e994\/59105965\/usae430.pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,9,18]],"date-time":"2025-09-18T19:44:45Z","timestamp":1758224685000},"score":1,"resource":{"primary":{"URL":"https:\/\/academic.oup.com\/milmed\/article\/190\/5-6\/e994\/7756357"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2024,9,12]]},"references-count":32,"journal-issue":{"issue":"5-6","published-online":{"date-parts":[[2024,9,12]]},"published-print":{"date-parts":[[2025,4,23]]}},"URL":"https:\/\/doi.org\/10.1093\/milmed\/usae430","relation":{},"ISSN":["0026-4075","1930-613X"],"issn-type":[{"value":"0026-4075","type":"print"},{"value":"1930-613X","type":"electronic"}],"subject":[],"published-other":{"date-parts":[[2025,5]]},"published":{"date-parts":[[2024,9,12]]}}}