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. Author manuscript; available in PMC: 2016 Aug 1.
Published in final edited form as: Shock. 2015 Aug;44(0 1):63–70. doi: 10.1097/SHK.0000000000000376

Figure 2. COMBAT Biological Sample Processing Chart.

Figure 2

This guide is carried by the COMBAT technical staff to aid in proper sample handling and allocation. Five sodium citrate (blue top), one lithium heparin (green), one EDTA, and one protease inhibitor vacuum tube are collected at each time point. One citrate and the EDTA tube are sent to the DHMC central clinical laboratory for a CBC and conventional coagulation tests. The protease inhibitor tube is immediately chilled and centrifuged to yield plasma. The remaining tubes are processed according to this chart. Whole blood undergoes a battery of 12 channels of viscoelastic hemostatic assays on the TEG® and ROTEM® platforms, including TEG® Platelet Mapping™ as well as ROTEM® platelet aggregometry. The remaining blood is immediately chilled, centrifuged to yield platelet free plasma and flash frozen in liquid nitrogen. These plasma samples are used for coagulation factor level tests (II, V, VII, X, and XIII), cytokine and chemokine panels, proteomics, metabolomics, and ELISAs for proteins of specific interest relevant to trauma induced coagulopathy, including tPA, PAI-1, syndecan and α-enolase. Aliquots are also contributed to the Trans Agency Research Consortium for Trauma-Induced Coagulopathy (TACTIC) collaboration.