Document Detail


Investigation of the effect of kaolin and tissue-factor-activated citrated whole blood, on clot-forming variables, as evaluated by thromboelastography.
MedLine Citation:
PMID:  18657078     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
BACKGROUND: The Thrombelastograph (TEG; Haemoscope Corp.) analyzes clot formation in whole blood (WB) and treatment based on this analysis has been shown to reduce transfusion requirements in liver and cardiac surgery when compared to conventional coagulation analysis. Implementing TEG as a routine laboratory-based analysis, however, requires validation of the activators employed and the effect of storage of the WB sample in citrate before analysis. STUDY DESIGN AND METHODS: The effect of kaolin, tissue factor (TF) 1:17,000, or TF 1:42,500 on TEG clotting time (R), Angle (velocity of clot formation), and maximum clot strength (amplitude [MA]) were evaluated, together with day-to-day variation, the coefficient of variance (CV%), and the effect of citrate storage time. RESULTS: Clot formation variables were equally affected by TF 1:17,000 and kaolin activation, whereas R was significantly longer when TF 1:42,500 was used. The CV for the different variables varied from 3 to 13 percent with no significant differences between assays. Storage of citrated WB significantly affected the TEG variables in a hypercoagulable direction. Only the R, however, was significantly affected (12%) when samples rested for 0 and 30 minutes were evaluated with kaolin as the activator. CONCLUSION: The TEG assays evaluated were reproducible and present with an acceptable CV% for routine clinical practice. Kaolin and TF 1:17,000 equally affected the clot formation variables. Storage of WB for up to 30 minutes in citrate did not, except for R, affect clot formation variables when kaolin was used as activator allowing for immediate analysis when the sample arrives in the laboratory.
Authors:
Pär I Johansson; Louise Bochsen; Søren Andersen; Dorthe Viuff
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Publication Detail:
Type:  Journal Article     Date:  2008-07-22
Journal Detail:
Title:  Transfusion     Volume:  48     ISSN:  1537-2995     ISO Abbreviation:  Transfusion     Publication Date:  2008 Nov 
Date Detail:
Created Date:  2008-12-04     Completed Date:  2009-01-15     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  0417360     Medline TA:  Transfusion     Country:  United States    
Other Details:
Languages:  eng     Pagination:  2377-83     Citation Subset:  IM    
Affiliation:
Department of Clinical Immunology, Rigshospitalet, University of Copenhagen, Copenhagen, Denmark. per.johansson@rh.regionh.dk
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MeSH Terms
Descriptor/Qualifier:
Adult
Anticoagulants / pharmacology
Blood Coagulation / drug effects*
Blood Preservation
Citrates / pharmacology
Dose-Response Relationship, Drug
Drug Interactions
Female
Fibrinolysis / drug effects
Hemostasis / drug effects
Humans
Kaolin / pharmacology*
Male
Reproducibility of Results
Thrombelastography*
Thromboplastin / pharmacology*
Chemical
Reg. No./Substance:
0/Anticoagulants; 0/Citrates; 1332-58-7/Kaolin; 9035-58-9/Thromboplastin

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


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