Limits...
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.

Show MeSH

Related in: MedlinePlus

Differences between citrated non-activated (CN) and citrated kaolin-activated (CK) method for each parameter after 0, 15 and 30 minutes. Little sign means statically significant differences between methods within the same time group and error bars represent SD. R – reaction time, time from the start of 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, angle formed by the slope between the amplitude of the trace at 2 mm and 20 mm; MA, maximum clot amplitude; LY 30 and LY 60, level of fibrinolysis at 30 and 60 min, respectively, after MA was reached. * means p < 0.05; ** means p < 0.01; *** means p < 0.001. Manufacturer references for citrated non-activated method: R 9–27 minutes, K 2–9 minutes, alfa angle 22–58 degrees, MA 44–64 mm, LY 30 0-8%, LY 60 0-15%. Manufacturer references for citrated kaolin-activated method: R 2–8 minutes, K 1–3 minutes, alfa angle 55–78 degrees, MA 51–69 mm, LY 30 0-8%, LY 60 0-15%.
© Copyright Policy - open-access
Related In: Results  -  Collection

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

Fig3: Differences between citrated non-activated (CN) and citrated kaolin-activated (CK) method for each parameter after 0, 15 and 30 minutes. Little sign means statically significant differences between methods within the same time group and error bars represent SD. R – reaction time, time from the start of 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, angle formed by the slope between the amplitude of the trace at 2 mm and 20 mm; MA, maximum clot amplitude; LY 30 and LY 60, level of fibrinolysis at 30 and 60 min, respectively, after MA was reached. * means p < 0.05; ** means p < 0.01; *** means p < 0.001. Manufacturer references for citrated non-activated method: R 9–27 minutes, K 2–9 minutes, alfa angle 22–58 degrees, MA 44–64 mm, LY 30 0-8%, LY 60 0-15%. Manufacturer references for citrated kaolin-activated method: R 2–8 minutes, K 1–3 minutes, alfa angle 55–78 degrees, MA 51–69 mm, LY 30 0-8%, LY 60 0-15%.

Mentions: In the second step we compared the results of non-activated samples with the results of kaolin-activated samples of all time points 0, 15, 30 minutes. Significant differences (p < 0.05) between non-activated and kaolin-activated samples were found mostly in 0 group for parameters R, K and alfa angle (Figure 3). After elapsing 15 and 30 minutes, there was no significant difference in TEG parameter (Figure 3) (p > 0.05).Figure 3


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

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

Differences between citrated non-activated (CN) and citrated kaolin-activated (CK) method for each parameter after 0, 15 and 30 minutes. Little sign means statically significant differences between methods within the same time group and error bars represent SD. R – reaction time, time from the start of 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, angle formed by the slope between the amplitude of the trace at 2 mm and 20 mm; MA, maximum clot amplitude; LY 30 and LY 60, level of fibrinolysis at 30 and 60 min, respectively, after MA was reached. * means p < 0.05; ** means p < 0.01; *** means p < 0.001. Manufacturer references for citrated non-activated method: R 9–27 minutes, K 2–9 minutes, alfa angle 22–58 degrees, MA 44–64 mm, LY 30 0-8%, LY 60 0-15%. Manufacturer references for citrated kaolin-activated method: R 2–8 minutes, K 1–3 minutes, alfa angle 55–78 degrees, MA 51–69 mm, LY 30 0-8%, LY 60 0-15%.
© Copyright Policy - open-access
Related In: Results  -  Collection

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

Fig3: Differences between citrated non-activated (CN) and citrated kaolin-activated (CK) method for each parameter after 0, 15 and 30 minutes. Little sign means statically significant differences between methods within the same time group and error bars represent SD. R – reaction time, time from the start of 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, angle formed by the slope between the amplitude of the trace at 2 mm and 20 mm; MA, maximum clot amplitude; LY 30 and LY 60, level of fibrinolysis at 30 and 60 min, respectively, after MA was reached. * means p < 0.05; ** means p < 0.01; *** means p < 0.001. Manufacturer references for citrated non-activated method: R 9–27 minutes, K 2–9 minutes, alfa angle 22–58 degrees, MA 44–64 mm, LY 30 0-8%, LY 60 0-15%. Manufacturer references for citrated kaolin-activated method: R 2–8 minutes, K 1–3 minutes, alfa angle 55–78 degrees, MA 51–69 mm, LY 30 0-8%, LY 60 0-15%.
Mentions: In the second step we compared the results of non-activated samples with the results of kaolin-activated samples of all time points 0, 15, 30 minutes. Significant differences (p < 0.05) between non-activated and kaolin-activated samples were found mostly in 0 group for parameters R, K and alfa angle (Figure 3). After elapsing 15 and 30 minutes, there was no significant difference in TEG parameter (Figure 3) (p > 0.05).Figure 3

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