Document Detail


Discard volume necessary for elimination of heparin flush effect on thromboelastography.
MedLine Citation:
PMID:  19851087     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
Heparin is commonly used to prevent obstruction of indwelling arterial catheters with blood clots. It is known to affect the outcomes of analysis of coagulation parameters with thromboelastography (TEG); therefore, it has been recommended to neutralize its effect with heparinase. However, heparinase may also neutralize the effect of low molecular weight heparin and endogenous heparinoids present in critically ill patients and thus yields unreliable results. The aim of this study was to evaluate the minimal discard blood volume needed to eliminate the effect of heparin flush on TEG parameters without the use of heparinase. Ten patients with indwelling arterial catheter were included in the study. Coagulation parameters were evaluated with kaolin-activated TEG. Blood samples were obtained after discarding 1, 2, 3, 4, 5 or 10 ml of blood to eliminate the effect of heparin. We investigated the influence of the discard volume on time until the first detectable clot (R), speed of clot development (alpha angle), maximal amplitude of the measured clot and time to maximal amplitude of the measured clot. We found an increase in coagulation (reflecting the heparin elimination) with the increasing discard volume between 1 and 4 ml. This was obvious from an increase in alpha angle and maximal amplitude of the measured clot and a decrease in R and time to maximal amplitude of the measured clot (P < 0.001). However, values obtained after discarding 4, 5 and 10 ml of blood did not differ markedly. To obtain valid information about TEG parameters, it is necessary to discard volume of at least 4 ml of blood (i.e., five times the volume of catheter dead space).
Authors:
Miroslav Durila; Tom?s Kalinc?k; Zuzana Pac?kov?; Karel Cvachovec
Related Documents :
20963447 - Regional citrate anticoagulation--a safe and effective procedure in pediatric apheresis...
2746467 - Development of anthron, an antithrombogenic coating for angiographic catheters.
8807717 - Quantitative determination of hirudin in blood and body fluids.
2133227 - Thrombin activity induced by balloon angioplasty of the coronary artery in macaca fasci...
2400627 - The valency state of absorbed iron appearing in the portal blood and ceruloplasmin subs...
1033517 - Effects of acute cold exposure on the distribution of cardiac output in the sheep.
Publication Detail:
Type:  Journal Article; Research Support, Non-U.S. Gov't    
Journal Detail:
Title:  Blood coagulation & fibrinolysis : an international journal in haemostasis and thrombosis     Volume:  21     ISSN:  1473-5733     ISO Abbreviation:  Blood Coagul. Fibrinolysis     Publication Date:  2010 Mar 
Date Detail:
Created Date:  2010-02-01     Completed Date:  2010-04-20     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  9102551     Medline TA:  Blood Coagul Fibrinolysis     Country:  England    
Other Details:
Languages:  eng     Pagination:  192-5     Citation Subset:  IM    
Affiliation:
Department of Anesthesiology and Critical Care Medicine, Second Faculty of Medicine and Institute for Postgraduate Medical Education, Charles University in Prague, Prague, Czech Republic. durila4@yahoo.com
Export Citation:
APA/MLA Format     Download EndNote     Download BibTex
MeSH Terms
Descriptor/Qualifier:
Adult
Aged
Female
Heparin / metabolism*
Humans
Male
Middle Aged
Thrombelastography / methods*
Young Adult
Chemical
Reg. No./Substance:
9005-49-6/Heparin

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


Previous Document:  Calcinosis Cutis: A Rare Reaction to Subcutaneous Injections of Calcium-Containing Heparin in Patien...
Next Document:  Cerebral venous thrombosis initially presenting with left occipital hemorrhage and headache.