Document Detail


A comparison of kaolin-activated versus nonkaolin-activated thromboelastography in native and citrated blood.
MedLine Citation:
PMID:  18685432     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
Thromboelastography can be performed with native or citrated blood (a surrogate to native blood in healthy controls, surgical and cirrhotic patients). Activators such as kaolin are increasingly used to reduce the time to trace generation. To compare kaolin-activated thromboelastography with nonkaolin-activated thromboelastography of native and citrated blood in patients with liver disease, patients undergoing treatment with warfarin or low-molecular weight heparin and healthy volunteers. We studied thromboelastography parameters in 21 healthy volunteers (group 1) and 50 patients, including 20 patients with liver cirrhosis with a nonbiliary aetiology (group 2), 10 patients with primary biliary cirrhosis or primary sclerosing cholangitis (group 3), 10 patients on warfarin treatment (group 4) and 10 patients with enoxaparin prophylaxis (group 5). Thromboelastography was performed using four methods: native blood (kaolin-activated and nonkaolin-activated) and citrated blood (kaolin-activated and nonkaolin-activated). For all thromboelastography parameters, correlation was poor (Spearman correlation coefficient < 0.70) between nonkaolin-activated and kaolin-activated thromboelastography, for both citrated and native blood. In healthy volunteers, in patients with liver disease and in those receiving anticoagulant treatment, there was a poor correlation between nonkaolin-activated and kaolin-activated thromboelastography. Kaolin-activated thromboelastography needs further validation before routine clinical use in these settings, and the specific methodology must be considered in comparing published studies.
Authors:
Ulrich Thalheimer; Christos K Triantos; Dimitrios N Samonakis; Andrea Zambruni; Marco Senzolo; Gioacchino Leandro; David Patch; Andrew K Burroughs
Publication Detail:
Type:  Comparative Study; Journal Article; Validation Studies    
Journal Detail:
Title:  Blood coagulation & fibrinolysis : an international journal in haemostasis and thrombosis     Volume:  19     ISSN:  0957-5235     ISO Abbreviation:  Blood Coagul. Fibrinolysis     Publication Date:  2008 Sep 
Date Detail:
Created Date:  2008-08-07     Completed Date:  2008-11-24     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  9102551     Medline TA:  Blood Coagul Fibrinolysis     Country:  England    
Other Details:
Languages:  eng     Pagination:  495-501     Citation Subset:  IM    
Affiliation:
Sheila Sherlock Hepatobiliarypancreatic and Liver Transplantation Unit, Royal Free Hospital, London, UK.
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MeSH Terms
Descriptor/Qualifier:
Adult
Aged
Anticoagulants / pharmacology*
Artifacts
Blood Specimen Collection / methods*
Cholangitis, Sclerosing / blood
Citrates / pharmacology*
Enoxaparin / pharmacology,  therapeutic use
False Positive Reactions
Female
Hepatitis, Viral, Human / blood
Humans
International Normalized Ratio
Kaolin / pharmacology*
Liver Cirrhosis / blood
Liver Cirrhosis, Biliary / blood
Liver Diseases / blood*
Male
Middle Aged
Reference Standards
Reproducibility of Results
Sensitivity and Specificity
Thrombelastography / methods*,  standards
Warfarin / pharmacology,  therapeutic use
Chemical
Reg. No./Substance:
0/Anticoagulants; 0/Citrates; 0/Enoxaparin; 1332-58-7/Kaolin; 18996-35-5/sodium citrate; 81-81-2/Warfarin

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


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