Can Thromboelastography performed on kaolin-activated citrated samples from critically ill patients provide stable and consistent parameters?

White, H, Zollinger, C, Jones, M and Bird, R (2009) Can Thromboelastography performed on kaolin-activated citrated samples from critically ill patients provide stable and consistent parameters?. International Journal of Laboratory Hematology, 32 2: 167-173. doi:10.1111/j.1751-553X.2009.01152.x


Author White, H
Zollinger, C
Jones, M
Bird, R
Title Can Thromboelastography performed on kaolin-activated citrated samples from critically ill patients provide stable and consistent parameters?
Journal name International Journal of Laboratory Hematology   Check publisher's open access policy
ISSN 1751-5521
Publication date 2009-03-17
Year available 2009
Sub-type Article (original research)
DOI 10.1111/j.1751-553X.2009.01152.x
Volume 32
Issue 2
Start page 167
End page 173
Total pages 7
Editor Dr. Steve Kitchen
William G Finn
Place of publication United Kingdom
Publisher Wiley-Blackwell Publishing Ltd
Collection year 2010
Language eng
Subject C1
92 Health
11 Medical and Health Sciences
Abstract Thromboelastography (TEG®) is a potentially useful tool but analysis within 4-6 min of collection imposes limitations on its use and access. The use of citrate blood tubes potentially increases the time frame for processing specimens. There is, however, limited research on the stability of citrate specimens, timing of processing and the accuracy of TEG® results. The purpose of this study was to examine the effects of early and delayed processing on TEG® parameters using kaolin-activated citrated blood samples in the intensive care population. TEG® analysis was performed on 61 patients. Blood was collected into two 3.2% sodium citrate (0.105 m) tubes. Kaolin-activated samples were analysed at 15, 30 and 120 min postcollection. TEG® parameters analysed included reaction time (R), clot formation time (K), alpha angle (α), maximum amplitude, LY30, the coagulation index, time to maximum rate of thrombus generation, maximum rate of thrombus generation and total thrombus generation. Sixty-one critically ill patients were included. The results of the anova showed that time from collection was significantly associated with the TEG® results (P < 0.05). On comparison of individual outcome variables, this difference in most cases was due to changes over time from 30 to 120 min. Furthermore, progressive changes in TEG® parameters such as decreasing R were suggestive of a trend toward hypercoagulability of the specimens. Processing of kaolin-activated citrate TEG® specimens can begin as early as 15 min postvenipuncture. However, delaying processing by more than 30 min leads to a significant change in results.
Keyword Thromboelastography
citrate
intensive care
coagulation
COAGULATION TESTS
PERIOPERATIVE HEMOSTASIS
LIVER-TRANSPLANTATION
BLOOD
THROMBELASTOGRAPHY
MANAGEMENT
HEPARIN
STORAGE
Q-Index Code C1
Q-Index Status Confirmed Code

Document type: Journal Article
Sub-type: Article (original research)
Collections: 2010 Higher Education Research Data Collection
School of Public Health Publications
School of Medicine Publications
 
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Created: Sun, 14 Mar 2010, 00:05:14 EST