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Time impact on non-activated and kaolin-activated blood samples in thromboelastography.

Durila M, Lukáš P, Bronský J, Cvachovec K - BMC Anesthesiol (2015)

Bottom Line: Blood samples obtained from 10 healthy volunteers were analyzed after 0, 15 and 30 minutes from sampling with kaolin activation and without activation.Then the results were analysed and compared between the non-activated and the kaolin-activated method.Although the kaolin-activated method can also be used, results must be interpreted with caution.

View Article: PubMed Central - PubMed

Affiliation: Department of Anaesthesiology and Intensive Care Medicine, Second Faculty of Medicine, Charles University in Prague, University Hospital Motol, V Úvalu 84, 150 06, Prague, 5, Czech Republic. durila4@gmail.com.

ABSTRACT

Background: The correct methodology of thrombelastography might be influenced by elapsing time. In our study we investigated kaolin activated citrated samples together with non-activated citrated samples in relation to the elapsed times of 0, 15 and 30 minutes to compare both methods and to find out if there is an impact of time on results of thrombelastography.

Methods: Blood samples obtained from 10 healthy volunteers were analyzed after 0, 15 and 30 minutes from sampling with kaolin activation and without activation. Then the results were analysed and compared between the non-activated and the kaolin-activated method.

Results: All blood samples became more hypercoagulable with the time elapsing, both in non-activated and kaolin-activated samples and differences between both groups were found statistically and clinically significant after only 0 minutes.

Conclusions: The non-activated citrated method seems to be reliable and suitable for thrombelastography in non-emergency cases (planned surgical procedures) when we have time to wait 15-30 minutes to get results. In urgent situations a rapid thrombelastography test should be preferred. Although the kaolin-activated method can also be used, results must be interpreted with caution.

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Differences of parameters in citrated non-activated (CN) group among 0, 15, 30 minutes. Little sign means statistical differences and error bars represent SD. R – reaction time, time from the start of the sample run to the first detectable clot formation (amplitude =2 mm); K – time from R to the clot amplitude of 20 mm (to specify the kinetics of the clot development); alfa angle, the angle formed by the slope between the amplitude of the trace at 2 mm and 20 mm; MA, maximum clot amplitude; CI, coagulation index; LY 30 and LY 60, level of fibrinolysis at 30 and 60 min, respectively, after MA was reached. * means significant differences between CN 0 min vs. CN 15 min and between CN 0 min vs. CN 30 min, p < 0.05; # means significant difference between CN 0 min vs. CN 30 min, p < 0.05; x means non-significant difference between CN 15 min vs. CN 30 min, p > 0.05.
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Fig1: Differences of parameters in citrated non-activated (CN) group among 0, 15, 30 minutes. Little sign means statistical differences and error bars represent SD. R – reaction time, time from the start of the sample run to the first detectable clot formation (amplitude =2 mm); K – time from R to the clot amplitude of 20 mm (to specify the kinetics of the clot development); alfa angle, the angle formed by the slope between the amplitude of the trace at 2 mm and 20 mm; MA, maximum clot amplitude; CI, coagulation index; LY 30 and LY 60, level of fibrinolysis at 30 and 60 min, respectively, after MA was reached. * means significant differences between CN 0 min vs. CN 15 min and between CN 0 min vs. CN 30 min, p < 0.05; # means significant difference between CN 0 min vs. CN 30 min, p < 0.05; x means non-significant difference between CN 15 min vs. CN 30 min, p > 0.05.

Mentions: In all measurements, both non-activated and kaolin activated, the time elapsed from blood sampling played a role and the samples became more hypercoagulable. The most significant time effect (p < 0.05) occurred within the first 15 minutes (between 0 and 15 minutes) both for non-activated and kaolin activated samples. After 15 minutes (between 15 and 30 minutes) time does not seem to play a significant role and the results do not differ significantly (p > 0.05) in either group (Figures 1 and 2). Interestingly, we found that CI in the non-activated method was nearest to 0 after 15 minutes whereas in kaolin-activated method was nearest to 0 after 30 minutes (Figures 1 and 2).Figure 1


Time impact on non-activated and kaolin-activated blood samples in thromboelastography.

Durila M, Lukáš P, Bronský J, Cvachovec K - BMC Anesthesiol (2015)

Differences of parameters in citrated non-activated (CN) group among 0, 15, 30 minutes. Little sign means statistical differences and error bars represent SD. R – reaction time, time from the start of the sample run to the first detectable clot formation (amplitude =2 mm); K – time from R to the clot amplitude of 20 mm (to specify the kinetics of the clot development); alfa angle, the angle formed by the slope between the amplitude of the trace at 2 mm and 20 mm; MA, maximum clot amplitude; CI, coagulation index; LY 30 and LY 60, level of fibrinolysis at 30 and 60 min, respectively, after MA was reached. * means significant differences between CN 0 min vs. CN 15 min and between CN 0 min vs. CN 30 min, p < 0.05; # means significant difference between CN 0 min vs. CN 30 min, p < 0.05; x means non-significant difference between CN 15 min vs. CN 30 min, p > 0.05.
© Copyright Policy - open-access
Related In: Results  -  Collection

License 1 - License 2
Show All Figures
getmorefigures.php?uid=PMC4404121&req=5

Fig1: Differences of parameters in citrated non-activated (CN) group among 0, 15, 30 minutes. Little sign means statistical differences and error bars represent SD. R – reaction time, time from the start of the sample run to the first detectable clot formation (amplitude =2 mm); K – time from R to the clot amplitude of 20 mm (to specify the kinetics of the clot development); alfa angle, the angle formed by the slope between the amplitude of the trace at 2 mm and 20 mm; MA, maximum clot amplitude; CI, coagulation index; LY 30 and LY 60, level of fibrinolysis at 30 and 60 min, respectively, after MA was reached. * means significant differences between CN 0 min vs. CN 15 min and between CN 0 min vs. CN 30 min, p < 0.05; # means significant difference between CN 0 min vs. CN 30 min, p < 0.05; x means non-significant difference between CN 15 min vs. CN 30 min, p > 0.05.
Mentions: In all measurements, both non-activated and kaolin activated, the time elapsed from blood sampling played a role and the samples became more hypercoagulable. The most significant time effect (p < 0.05) occurred within the first 15 minutes (between 0 and 15 minutes) both for non-activated and kaolin activated samples. After 15 minutes (between 15 and 30 minutes) time does not seem to play a significant role and the results do not differ significantly (p > 0.05) in either group (Figures 1 and 2). Interestingly, we found that CI in the non-activated method was nearest to 0 after 15 minutes whereas in kaolin-activated method was nearest to 0 after 30 minutes (Figures 1 and 2).Figure 1

Bottom Line: Blood samples obtained from 10 healthy volunteers were analyzed after 0, 15 and 30 minutes from sampling with kaolin activation and without activation.Then the results were analysed and compared between the non-activated and the kaolin-activated method.Although the kaolin-activated method can also be used, results must be interpreted with caution.

View Article: PubMed Central - PubMed

Affiliation: Department of Anaesthesiology and Intensive Care Medicine, Second Faculty of Medicine, Charles University in Prague, University Hospital Motol, V Úvalu 84, 150 06, Prague, 5, Czech Republic. durila4@gmail.com.

ABSTRACT

Background: The correct methodology of thrombelastography might be influenced by elapsing time. In our study we investigated kaolin activated citrated samples together with non-activated citrated samples in relation to the elapsed times of 0, 15 and 30 minutes to compare both methods and to find out if there is an impact of time on results of thrombelastography.

Methods: Blood samples obtained from 10 healthy volunteers were analyzed after 0, 15 and 30 minutes from sampling with kaolin activation and without activation. Then the results were analysed and compared between the non-activated and the kaolin-activated method.

Results: All blood samples became more hypercoagulable with the time elapsing, both in non-activated and kaolin-activated samples and differences between both groups were found statistically and clinically significant after only 0 minutes.

Conclusions: The non-activated citrated method seems to be reliable and suitable for thrombelastography in non-emergency cases (planned surgical procedures) when we have time to wait 15-30 minutes to get results. In urgent situations a rapid thrombelastography test should be preferred. Although the kaolin-activated method can also be used, results must be interpreted with caution.

Show MeSH
Related in: MedlinePlus