Fresh and citrated whole-blood specimens can produce different thromboelastography results in patients on extracorporeal membrane oxygenation.

Abstract:

OBJECTIVES:To compare thromboelastography (TEG) tracings obtained from fresh and citrated whole-blood samples in patients on extracorporeal membrane oxygenation (ECMO) or after cardiopulmonary bypass and in healthy volunteers. METHODS:Samples of fresh and citrated whole blood were analyzed for 25 patients and 4 healthy volunteers. Thromboelastography analysis was performed in both plain and heparinase cups. RESULTS:In 5 of 6 patients on ECMO, use of citrated samples resulted in apparent partial or complete heparin reversal. In TEG tracings from patients following cardiopulmonary bypass, there was a slight hypercoagulable appearance in the citrated sample. No differences were noted between fresh and citrated samples from healthy volunteers whose blood was spiked with heparin. CONCLUSIONS:In some patients on ECMO, use of samples collected in sodium citrate tubes for TEG analysis results in significant artifacts, which could lead to heparin overdosing in these patients.

journal_name

Am J Clin Pathol

authors

Gilman EA,Koch CD,Santrach PJ,Schears GJ,Karon BS

doi

10.1309/AJCPYIQ9JNNSEN4Q

subject

Has Abstract

pub_date

2013-08-01 00:00:00

pages

165-9

issue

2

eissn

0002-9173

issn

1943-7722

pii

140/2/165

journal_volume

140

pub_type

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