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Huegen BL, Doherty JL, Smith BN, Franklin AD. Role of Electrode Configuration and Morphology in Printed Prothrombin Time Sensors. SENSORS AND ACTUATORS. B, CHEMICAL 2024; 399:134785. [PMID: 37953965 PMCID: PMC10634633 DOI: 10.1016/j.snb.2023.134785] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/14/2023]
Abstract
Patients on long-term anticoagulation therapy require frequent testing of prothrombin time/international normalized ratio (PT/INR) to ensure therapeutic efficacy. Point-of-care (POC) PT tests for at-home monitoring eliminate the burden of visiting the clinic, but realizing a cost-effective and robust at-home POC test for PT has remained elusive. Recent demonstrations of printed PT sensors show promise for addressing the cost concerns; however, the printed sensors have lacked quality control to ensure reliability between tests. In this work, on-chip redundancy is introduced with fully printed impedimetric PT sensors by incorporating simultaneous testing with a single fingerstick volume of blood (8 μL). The influence of electrode dimensions and composition were studied, revealing an optimal electrode spacing of 200 μm and an unexpected dependence on the morphology of the electrodes. Three distinct silver morphologies were studied: aerosol jet printed silver nanoparticles (AgNPs), aerosol jet printed silver nanowires (AgNWs), and evaporated silver (Ag). In general, AgNPs exhibited the best PT sensor performance, due to relatively low conductance and high porosity. Overall, the printed impedimetric PT sensor functionalization was improved by incorporating simultaneous testing and, when combined with a handheld control device, shows promise for leading to a system that overcomes the challenges of commercial PT/INR coagulometers.
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Affiliation(s)
- Brittani L. Huegen
- Department of Electrical and Computer Engineering, Duke University, Durham NC 27708, USA
| | - James L. Doherty
- Department of Electrical and Computer Engineering, Duke University, Durham NC 27708, USA
| | - Brittany N. Smith
- Department of Electrical and Computer Engineering, Duke University, Durham NC 27708, USA
| | - Aaron D. Franklin
- Department of Electrical and Computer Engineering, Duke University, Durham NC 27708, USA
- Department of Chemistry, Duke University, Durham NC 27708, USA
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Chen C, Zhang M, Hao P, He F, Zhang X. An in silico analysis of unsteady flow structures in a microaxial blood pump under a pulsating rotation speed. COMPUTER METHODS AND PROGRAMS IN BIOMEDICINE 2024; 243:107919. [PMID: 37972458 DOI: 10.1016/j.cmpb.2023.107919] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/22/2023] [Revised: 11/02/2023] [Accepted: 11/05/2023] [Indexed: 11/19/2023]
Abstract
BACKGROUND AND OBJECTIVE Ventricular assist devices (VADs) are generally designed to perform continuous flow. However, it has been proven that continuous flow, which is not a physiological hemodynamic state, may cause severe complications such as gastrointestinal bleeding, pulmonary hypertension, and ventricular suction. For these reasons, many pulsating blood pump control strategies have been proposed and have the potential for application in percutaneous ventricular assist devices (pVADs) or microaxial blood pumps. A few cases report extra hemolysis when introducing pulsating speed, while none involve blood pumps. This research's primary purpose is to evaluate the potential hemolysis of pVAD under pulsating flow conditions. METHODS First, the pulsating flow state is deduced using a heart failure model and varying speed. The heart model is established according to the pathology state collected from a clinical check. The rotation speed and boundary physical state are set to fit the heart failure model. The computational fluid dynamics (CFD) method with the hemolysis prediction model is performed. Furthermore, we used proper orthogonal decomposition (POD) analysis to reconstruct the flow field and obtain more details about shearing and transporting effects. RESULTS (1) As a variable rotational speed was introduced, no significant gain in hemolysis accumulation appeared in pVAD. This is quite different from long-term implantable VADs. (2) Pulsation affects hemolysis mainly through pressure (or normal stress). Variable rotational speed affects hemolysis mainly through flow instability. (3) Variable rotational speed will increase the instability and influence hemolysis by transporting and shearing effects, while the transporting effect is more significant. CONCLUSIONS The unsteady flow state will affect the spatial distribution of hemolysis, which should be taken into account during control strategy and impeller shape design.
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Affiliation(s)
- Chenghan Chen
- Applied Mechanics Laboratory, Department of Engineering Mechanics, School of Aerospace Engineering, Tsinghua University, Beijing, PR China; Department of Cardiovascular Surgery, First Hospital of Tsinghua University, Beijing, PR China
| | - Mingkui Zhang
- Department of Cardiovascular Surgery, First Hospital of Tsinghua University, Beijing, PR China
| | - Pengfei Hao
- Applied Mechanics Laboratory, Department of Engineering Mechanics, School of Aerospace Engineering, Tsinghua University, Beijing, PR China
| | - Feng He
- Applied Mechanics Laboratory, Department of Engineering Mechanics, School of Aerospace Engineering, Tsinghua University, Beijing, PR China
| | - Xiwen Zhang
- Applied Mechanics Laboratory, Department of Engineering Mechanics, School of Aerospace Engineering, Tsinghua University, Beijing, PR China.
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Kasireddy N, Luo D, Khismatullin DB. Whole blood PT/aPTT assay based on non-contact drop-of-sample acoustic tweezing spectroscopy. Anal Bioanal Chem 2024; 416:323-327. [PMID: 37996618 DOI: 10.1007/s00216-023-05052-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/03/2023] [Revised: 10/25/2023] [Accepted: 11/13/2023] [Indexed: 11/25/2023]
Abstract
Most coagulation tests are photo-optical turbidimetric assays that require the removal of cellular components from whole blood for optical clearing. If the resulting blood plasma samples are hemolyzed, they may become unsuitable for turbidimetric analysis. To resolve this issue, whole-blood analogs to plasma turbidimetric assays need to be developed. Using samples collected from non-smokers (normal group), smokers (thrombotic group), and hemophilia A (bleeding group) patients, we demonstrate that the reaction time assessed from whole blood viscosity data of the drop-of-blood acoustic tweezing spectroscopy (ATS) technique strongly correlates (Rp ≥ 0.95) with PT/aPTT values obtained from plasma turbidimetric data. Linear correlation (Rp ≥ 0.88) was also obtained between the viscous and elastic outputs of the ATS technique and the fibrinogen concentration. The integration of ATS data enabled the assessment of the functional level of fibrin cross-linkers such as factor XIII. Overall, ATS allows comprehensive sample-sparing analysis of whole blood coagulation for reliable and safe diagnosis of bleeding/thrombosis risks.
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Affiliation(s)
- Nithya Kasireddy
- Department of Biomedical Engineering and Tulane Institute for Integrative Engineering for Health and Medicine, Tulane University, 6823 St. Charles Avenue, 500 Lindy Boggs Center, New Orleans, LA, 70118, USA
- Levisonics Inc, New Orleans, LA, USA
| | - Daishen Luo
- Department of Biomedical Engineering and Tulane Institute for Integrative Engineering for Health and Medicine, Tulane University, 6823 St. Charles Avenue, 500 Lindy Boggs Center, New Orleans, LA, 70118, USA
| | - Damir B Khismatullin
- Department of Biomedical Engineering and Tulane Institute for Integrative Engineering for Health and Medicine, Tulane University, 6823 St. Charles Avenue, 500 Lindy Boggs Center, New Orleans, LA, 70118, USA.
- Levisonics Inc, New Orleans, LA, USA.
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Charlès L, Agius T, Filz von Reiterdank I, Hagedorn J, Berkane Y, Lancia HH, Uygun BE, Uygun K, Cetrulo CL, Randolph MA, Lellouch AG. Modified Tail Vein and Penile Vein Puncture for Blood Sampling in the Rat Model. J Vis Exp 2023:10.3791/65513. [PMID: 37458471 PMCID: PMC10910861 DOI: 10.3791/65513] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 07/20/2023] Open
Abstract
Blood samples are required in most experimental animal designs to assess various hematological parameters. This paper presents two procedures for blood collection in rats: the lateral tail vein puncture and the dorsal penile vein puncture, which offer significant advantages over other previously described techniques. This study shows that these two procedures allow for fast sampling (under 10 min) and yield sufficient blood volumes for most assays (202 μL ± 67.7 μL). The dorsal penile vein puncture must be done under anesthesia, whereas the lateral tail vein puncture can be done on a conscious, restrained animal. Alternating these two techniques, therefore, enables blood draw in any situation. While it is always recommended for an operator to be assisted during a procedure to ensure animal welfare, these techniques require only a single operator, unlike most blood sampling methods that require two. Moreover, whereas these previously described methods (e.g., jugular stick, subclavian vein blood draw) require extensive prior training to avoid harm to or death of the animal, tail vein and dorsal penile vein puncture are rarely fatal. For all these reasons, and according to the context (e.g., for studies including male rats, during the perioperative or immediate postoperative period, for animals with thin tail veins), both techniques can be used alternately to enable repeated blood draws.
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Affiliation(s)
- Laura Charlès
- Vascularized Composite Allotransplantation Laboratory, Massachusetts General Hospital; Harvard Medical School; Shriners Children's Boston
| | - Thomas Agius
- Center for Engineering in Medicine and Surgery, Massachusetts General Hospital; Department of Vascular Surgery, Centre Hospitalier Universitaire Vaudois and University of Lausanne
| | - Irina Filz von Reiterdank
- Vascularized Composite Allotransplantation Laboratory, Massachusetts General Hospital; Harvard Medical School; Shriners Children's Boston; Department of Plastic, Reconstructive and Hand Surgery, University Medical Center Utrecht
| | - Janna Hagedorn
- Vascularized Composite Allotransplantation Laboratory, Massachusetts General Hospital; Harvard Medical School; Shriners Children's Boston
| | - Yanis Berkane
- Vascularized Composite Allotransplantation Laboratory, Massachusetts General Hospital; Harvard Medical School; Shriners Children's Boston; Department of Plastic, Reconstructive and Aesthetic Surgery, Rennes University Hospital Center (CHU de Rennes), Rennes 1 University
| | - Hyshem H Lancia
- Vascularized Composite Allotransplantation Laboratory, Massachusetts General Hospital; Harvard Medical School; Shriners Children's Boston
| | - Basak E Uygun
- Harvard Medical School; Shriners Children's Boston; Center for Engineering in Medicine and Surgery, Massachusetts General Hospital
| | - Korkut Uygun
- Harvard Medical School; Shriners Children's Boston; Center for Engineering in Medicine and Surgery, Massachusetts General Hospital
| | - Curtis L Cetrulo
- Vascularized Composite Allotransplantation Laboratory, Massachusetts General Hospital; Harvard Medical School; Shriners Children's Boston; Plastic Surgery Research Laboratory, Massachusetts General Hospital
| | - Mark A Randolph
- Vascularized Composite Allotransplantation Laboratory, Massachusetts General Hospital; Harvard Medical School; Shriners Children's Boston; Plastic Surgery Research Laboratory, Massachusetts General Hospital
| | - Alexandre G Lellouch
- Vascularized Composite Allotransplantation Laboratory, Massachusetts General Hospital; Harvard Medical School; Shriners Children's Boston; Center for Engineering in Medicine and Surgery, Massachusetts General Hospital;
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Liang L, Li X, Liu B, Zhang Q, He X, Tan K, Rong F. Activated partial thromboplastin time as a potential biomarker for the diagnosis of tuberculous pleural effusion. Am J Med Sci 2023; 365:437-442. [PMID: 36283425 DOI: 10.1016/j.amjms.2022.09.023] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/23/2021] [Revised: 07/05/2022] [Accepted: 09/20/2022] [Indexed: 11/17/2022]
Abstract
BACKGROUND The aim of this study was to explore the difference in activated partial thromboplastin time (APTT) levels in patients with tuberculous and non-tuberculous pleural effusion (TPE and non-TPE) and its possible mechanism to provide a new direction for the diagnosis of pleural effusion (PE). METHODS A total of 61 patients diagnosed with tuberculous pleurisy with pleural effusion at Shunde Hospital of Southern Medical University from July 2013 to September 2020 were selected as the observation group (tuberculosis group). Another 89 patients (45 with malignant pleural effusion (MPE) and 44 with parapneumonic pleural effusion (PPE) composed the control group. The adenosine deaminase (ADA) level in pleural fluid and plasma APTT level were measured in the two groups. RESULTS The levels of APTT and ADA in the TPE group were significantly higher than the control group, and were 40.03 (37.00, 42.60) (s) and 55.00 (47.00, 69.25) (U/L) for TPE, 29.50 (25.45, 34.20) (s) and 11.90 (9.15, 19.05) (U/L) for malignant pleural effusion (MPE) and 31.35 (27.43, 35.76) (s) and 15.15 (7.40, 35.00) (U/L) for parapneumonic pleural effusion (PPE), respectively. CONCLUSIONS The level of plasma APTT has certain significance in differentiating tuberculous pleural effusion from nontuberculous pleural effusion.
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Affiliation(s)
- Laoqi Liang
- Shunde Hospital, Southern Medical University (the First People's Hospital of Shunde), Foshan, Guangdong 528300, China.
| | - Xi Li
- Shunde Hospital, Southern Medical University (the First People's Hospital of Shunde), Foshan, Guangdong 528300, China.
| | - Bin Liu
- Shunde Hospital, Southern Medical University (the First People's Hospital of Shunde), Foshan, Guangdong 528300, China.
| | - Qian Zhang
- Shunde Hospital, Southern Medical University (the First People's Hospital of Shunde), Foshan, Guangdong 528300, China.
| | - Xiaoyi He
- Shunde Hospital, Southern Medical University (the First People's Hospital of Shunde), Foshan, Guangdong 528300, China.
| | - Kunshu Tan
- Nanhai District People's Hospital of Foshan, Foshan, Guangdong 528200, China.
| | - Fu Rong
- Shunde Hospital, Southern Medical University (the First People's Hospital of Shunde), Foshan, Guangdong 528300, China.
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Negaard BJ, Hobbs R, Frye JR, Merrill AE. Propofol-induced interference with activated partial thromboplastin time-based monitoring of therapeutic heparin anticoagulation. Am J Health Syst Pharm 2023; 80:445-451. [PMID: 36370416 DOI: 10.1093/ajhp/zxac337] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/10/2022] [Indexed: 11/13/2022] Open
Abstract
PURPOSE The activated partial thromboplastin time (aPTT) is a coagulation assay commonly utilized for monitoring therapeutic heparin anticoagulation. aPTT methods based on optical detection are vulnerable to spectral interference from hemolysis, icterus, lipemia, and other substances. Intravenous lipid emulsions of primarily 20% have been shown to interfere with multiple clinical laboratory assays, including those measuring aPTT by optical methods, but there is limited data on propofol's effect. The primary objective of this study was to determine the rate of interference of propofol with aPTT measurements in patients receiving both propofol and intravenous heparin. METHODS A retrospective observational cohort study of intensive care unit patients who received concomitant propofol and heparin infusions (N = 38 patients) and whose heparin therapy was monitored by aPTT (N = 531 aPTTs) was conducted. Review of the electronic medical record was completed to obtain relevant clinical and laboratory data, while the laboratory information system was queried for analytical interference with the aPTT assay. RESULTS A total of 109 aPTTs (21%) spanning 21 patients (55%) had documented aPTT interference. All 21 patients had at least one aPTT requiring ultracentrifugation prior to reporting, and 12 aPTTs from 4 patients were unreportable due to interference. Patients with and without aPTT interference received similar doses of propofol. None of the cases of aPTT interference were caused by hemolysis or hyperbilirubinemia. CONCLUSION A potential medication-assay interaction was observed in approximately half of patients who received concomitant propofol and heparin infusions and had aPTT measured for anticoagulation management. Sample ultracentrifugation removes the optical interference in most cases but significantly prolongs aPTT reporting and delays appropriate adjustments to heparin dosing.
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Affiliation(s)
- Briana J Negaard
- Department of Pharmacy, Indiana University Health Methodist Hospital, Indianapolis, IN, USA
| | - Ryan Hobbs
- Department of Pharmaceutical Care, University of Iowa Hospitals & Clinics, Iowa City, IA, USA
| | - Jared R Frye
- Department of Pharmaceutical Care, University of Iowa Hospitals & Clinics, Iowa City, IA, USA
| | - Anna E Merrill
- Department of Pathology, University of Iowa Hospitals & Clinics, Iowa City, IA, USA
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El Azab EF, Saleh AM, Yousif SO, Mazhari BBZ, Abu Alrub H, Elfaki EM, Hamza A, Abdulmalek S. New insights into geraniol's antihemolytic, anti-inflammatory, antioxidant, and anticoagulant potentials using a combined biological and in silico screening strategy. Inflammopharmacology 2022; 30:1811-1833. [PMID: 35932440 DOI: 10.1007/s10787-022-01039-2] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/07/2022] [Accepted: 07/15/2022] [Indexed: 11/05/2022]
Abstract
The study aims to assess the antihemolytic and antioxidant activities of geraniol versus 2, 2'-azobis, 2-amidinopropane dihydro-chloride- (AAPH-) induced oxidative damage and hemolysis to erythrocytes and its anti-inflammatory potential against lipopolysaccharide- (LPS-) induced inflammation in white blood cells (WBCs) with a focus on its integrated computational strategies against different targeted receptors participating in inflammation and coagulation. The rats' erythrocyte suspension was incubated with different geraniol concentrations. Molecular docking and simulation were used to explore the possible interaction patterns of geraniol against the potential targeted proteins for therapeutic screening. The results displayed that geraniol had a prolonged noteworthy effect on activated partial thromboplastin time and thromboplastin time. Geraniol displayed strong antioxidant effects via reduced malondialdehyde (MDA) formation and increased GSH level and SOD activity. We observed dose-dependent prevention of K+ ion leakage along with a remarkable decline of hemolysis in erythrocytes pretreated with geraniol. Geraniol 100 µg/mL and diclofenac 100 µM were nontoxic to WBCs. Geraniol significantly reduces the expression and release of cellular pro-inflammatory factors TNF-α, IL-1β, IL-8, and nitric oxide, accompanied by a significant upregulation of gene expression of anti-inflammatory cytokine IL-10 in LPS-induced WBCs compared to nontreated cells. It demonstrates a much stronger inhibition potential than diclofenac in terms of inflammation inhibition. When comparing molecular docking and simulation data, current work showed that geraniol has a good affinity toward apoptosis signal-regulating kinase 1 (ASK1) and human P2Y12 receptors and could be developed as an antioxidant, anti-inflammatory, and anticoagulant medication in the future. Consequently, geraniol is recommended to have a defensive influence against oxidative stress, and hemolysis also could be developed as a promising anti-inflammatory, antioxidant, and anticoagulant medication.
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Affiliation(s)
- Eman Fawzy El Azab
- Department of Clinical Laboratory Sciences, College of Applied Medical Sciences at Al-Qurayyat, Jouf University, Al-Qurayyat, 77454, Saudi Arabia. .,Biochemistry Department, Faculty of Science, Alexandria University, Alexandria, 21511, Egypt.
| | - Abdulrahman M Saleh
- Pharmaceutical Medicinal Chemistry and Drug Design Department, Faculty of Pharmacy (Boys), Al-Azhar University, Cairo, 11884, Egypt
| | - Sara Osman Yousif
- Department of Clinical Laboratory Sciences, College of Applied Medical Sciences at Al-Qurayyat, Jouf University, Al-Qurayyat, 77454, Saudi Arabia.,Department of Clinical Chemistry, Faculty of Medical Laboratory Sciences, Sudan University of Science and Technology, Khartoum, Sudan
| | - Bi Bi Zainab Mazhari
- Department of Clinical Laboratory Sciences, College of Applied Medical Sciences at Al-Qurayyat, Jouf University, Al-Qurayyat, 77454, Saudi Arabia
| | - Heba Abu Alrub
- Department of Clinical Laboratory Sciences, College of Applied Medical Sciences at Al-Qurayyat, Jouf University, Al-Qurayyat, 77454, Saudi Arabia
| | - Elyasa Mustafa Elfaki
- Department of Clinical Laboratory Sciences, College of Applied Medical Sciences at Al-Qurayyat, Jouf University, Al-Qurayyat, 77454, Saudi Arabia
| | - Alneil Hamza
- Department of Clinical Laboratory Sciences, College of Applied Medical Sciences at Al-Qurayyat, Jouf University, Al-Qurayyat, 77454, Saudi Arabia
| | - Shaymaa Abdulmalek
- Biochemistry Department, Faculty of Science, Alexandria University, Alexandria, 21511, Egypt
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Ding Y, Wei Z, Li J, Zhu L. Effects of Metoprolol Succinate Combined with Entresto on Cardiac Function Indexes and Coagulation Function in Patients with Congestive Heart Failure. COMPUTATIONAL AND MATHEMATICAL METHODS IN MEDICINE 2022; 2022:9765884. [PMID: 35637842 PMCID: PMC9148243 DOI: 10.1155/2022/9765884] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/20/2022] [Revised: 04/11/2022] [Accepted: 04/19/2022] [Indexed: 11/17/2022]
Abstract
Objective To investigate the effects of metoprolol succinate combined with Entresto (Sacubitril Valsartan Sodium Tablets) on cardiac function and coagulation function in patients with congestive heart failure (CHF). Methods About 120 patients with CHF treated from April 2018 to April 2021 were enrolled in our hospital. The patients were arbitrarily assigned into control group and study group. The control group was cured with metoprolol succinate sustained-release tablets, and the study group was cured with metoprolol succinate sustained-release tablets combined with Entresto. The curative effect, cardiac function, vascular endothelial function, oxidative stress, and coagulation function were compared. Results First of all, we compared the general data, and there exhibited no difference in age, sex, course of disease, hypertension, coronary heart disease, diabetes, atrial fibrillation, and other general data (P > 0.05). Second, we compared the clinical efficacy. The effective rate of the study group (98.33%) was higher (90.00%) (P < 0.05). There exhibited no significant difference in cardiac function indexes before treatment, but after treatment, LVEF increased, LVESD and LVEDD decreased, LVESD and LVEDD in the study group were lower, and LVEF in the study group was higher (P < 0.05). Before treatment, there exhibited no significant difference in vascular endothelial function. However, the levels of CGRP and ET increased and the level of NO decreased, and the level of NO in the study group was lower, while the levels of CGRP and ET in the study group were higher after treatment (P < 0.05). There exhibited no significant difference in oxidative stress indexes before treatment, however, the levels of GSH-Px and SOD increased and the levels of MDA decreased after treatment, while the level of MDA in the study group was lower, while the levels of GSH-Px and SOD in the study group were higher (P < 0.05). Finally, we compared the indexes of blood coagulation function. There exhibited no significant difference before treatment, but after treatment, the levels of APTT, PT, and FIB decreased, and the levels of APTT, PT, and FIB in the study group were lower (P < 0.05). Conclusion Clinical practice demonstrated that LVESD and LVEDD decreased and LVEF increased after treatment with Entresto combined with metoprolol in CHF patients, which can effectively facilitate cardiac function and vascular endothelial function, reduce oxidative stress reaction, and improve blood coagulation indexes, suggesting that Entresto combined with metoprolol can improve ventricular remodeling with good safety.
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Affiliation(s)
- Yuanyuan Ding
- Hubei Province Huangshi Puren Hospital Cardiovascular Medicine, 435002, China
| | - Zufa Wei
- Hubei Province Huangshi Puren Hospital Cardiovascular Medicine, 435002, China
| | - Jian Li
- Hubei Province Huangshi Puren Hospital Cardiovascular Medicine, 435002, China
| | - Ling Zhu
- Audit Office of Huangshi Central Hospital, Hubei Province, China
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Pan LL, Lee CH, Hung KC, Tsai IT, Wang MC, Sun CK. Differential impacts of hemolysis on coagulation parameters of blood samples: A STROBE-compliant article. Medicine (Baltimore) 2021; 100:e25798. [PMID: 33950978 PMCID: PMC8104210 DOI: 10.1097/md.0000000000025798] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/12/2020] [Accepted: 04/15/2021] [Indexed: 01/04/2023] Open
Abstract
This study aimed at investigating the impact of hemolysis on different coagulation parameters.A total of 216 venous blood samples without visible hemolysis were collected from adult patients at a tertiary referral center over six months. The plasma obtained was quantified for six coagulation parameters including prothrombin time, activated partial thromboplastin time, fibrinogen, D-dimer, antithrombin III, and protein C. The rest of the plasma from each blood sample was aliquoted into three tubes, each containing 1 mL of plasma with three different volumes of cell-free hemoglobin (i.e., 2, 4, 8 μL) from lysed RBCs to create simulated hemolyzed blood samples with hemoglobin concentration of approximately 0.1, 0.2, and 0.4 g/dL to mimic mild (1+), moderate (2+), and severe (3+) hemolysis, respectively, before repeating the coagulation tests to determine possible correlation between the simulated degree of hemolysis and the changes in test results of the coagulation parameters.Spearman correlation analysis showed significant decreases in the values of activated partial thromboplastin time, fibrinogen, D-dimer, and protein C values with an increasing degree of simulated hemolysis (all P < .01). Comparison of the percentage bias of biological variance showed significant positive associations of cell-free hemoglobin concentrations with the percentage bias of D-dimer and protein C. However, only the former was still within the range of biological variance under condition of simulated hemolysis. Besides, the presence of cell-free hemoglobin regardless of concentration had a notable impact on the percentage bias of activated partial thromboplastin time, whereas the influence was non-significant for prothrombin time, fibrinogen, and antithrombin III.The results showed different impacts of simulated hemolysis on six coagulation parameters, highlighting the dependence of clinical reliability on the coagulation parameter to be investigated in hemolytic blood samples.
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Affiliation(s)
- Lin-Lin Pan
- Department of Laboratory Medicine, Chang Gung Memorial Hospital, Chiayi
- Department of Medical Laboratory Science and Biotechnology, Chung Hwa University of Medical Technology (CUMT)
| | - Ching-Hui Lee
- Department of Laboratory Medicine, Chang Gung Memorial Hospital, Chiayi
| | - Kuo-Chuan Hung
- Department of Anesthesiology, Chi Mei Medical Center, Tainan
| | - I-Ting Tsai
- Department of Emergency Medicine, E-Da Hospital
- School of Medicine, College of Medicine, I-Shou University
| | - Ming-Chung Wang
- Department of Internal medicine, Division of Hematology/Oncology, Kaohsiung Chang Gung Memorial Hospital, Kaohsiung, Taiwan
| | - Cheuk-Kwan Sun
- Department of Emergency Medicine, E-Da Hospital
- School of Medicine, College of Medicine, I-Shou University
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Brown L, Jennings I, Kitchen S, Kitchen DP, Woods TAL, Walker ID. Pre-analytical variables in haemostasis: Findings from the United Kingdom National External Quality Assessment scheme for Blood Coagulation (UK NEQAS BC) haemolysis exercise. Int J Lab Hematol 2021; 43:1198-1206. [PMID: 33605545 DOI: 10.1111/ijlh.13468] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/12/2020] [Revised: 12/15/2020] [Accepted: 12/27/2020] [Indexed: 11/30/2022]
Abstract
INTRODUCTION Haemolysis is considered one of the major contributors of nonconformities and sample rejection in coagulation testing. MATERIALS AND METHODS Two lyophilized plasmas were distributed to 800 centres registered for prothrombin time (PT), activated partial thromboplastin time (APTT) and either Clauss fibrinogen or thrombin time (TT) in the UK NEQAS BC programme. The same pool of normal plasma was used to prepare both samples, to one of which red blood cell haemolysate was added to mimic haemolysis at 3 g/L haemoglobin concentration. Participants were asked to complete a questionnaire about their laboratory approach to dealing with haemolysed samples, including strategies used to deal with different levels of haemolysis. RESULTS Results for tests performed did not show great differences between the two samples. It should be noted that artificially constructed haemolysed samples may not behave in the same way as patient samples (ie, may not be commutable). However, the possibility of carrying out a large multicentre study for detection of haemolysis was demonstrated. Inconsistency in practice was observed with 226/551 (41%) of centres indicated they reject haemolysed samples solely on visual checks, and 163 (30%) using initial visual checks with further sample rejection evaluation by analyser flags. Furthermore, 333 (72%) of centres indicated that the level of haemolysis affects sample rejection decisions, while 132 (28%) stated it did not. CONCLUSION Variability of responses for dealing with haemolysed samples reflects a lack of clear consistency in the pre-analytical area of sample processing.
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Affiliation(s)
- Lilia Brown
- UK NEQAS for Blood Coagulation, Sheffield, UK
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Delianu C, Moscalu M, Hurjui LL, Tărniceriu CC, Bădulescu OV, Lozneanu L, Hurjui I, Goriuc A, Surlari Z, Foia L. Chronometric vs. Structural Hypercoagulability. ACTA ACUST UNITED AC 2020; 57:medicina57010013. [PMID: 33379139 PMCID: PMC7823593 DOI: 10.3390/medicina57010013] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/16/2020] [Revised: 12/15/2020] [Accepted: 12/21/2020] [Indexed: 11/16/2022]
Abstract
Prolonged tourniquet stasis induced by venepuncture can lead to the release of the plasma of cell lysis products, as well as tissue factor (TF), impairing the quality of coagulation test results. The accidental presence of TF in vitro can trigger the coagulation mechanism, generating a false decrease in prothrombin time (PT). Background and Objectives: Identification of short PT tests below the normal reference value that could suggest a situation of hypercoagulability. The study aimed to compare the results of the shortened PT tests at their first determination with the eventual correction following duplication of the analysis from the same sample. Materials and methods: Identification of the shortened PT tests has been carried out for a period of 4 months, upon 544 coagulation samples referred to the Hematology department of Sf. Spiridon County Clinical Emergency Hospital from Iasi, Romania. Results: Out of the 544 samples of which the results indicated a state of hypercoagulability, by repeating the determination from the same sample, for 200 (36.76%) PT tests (p = 0.001) the value was corrected, falling within the normal reference range. For 344 (63.24%) tests, the results suggested a situation of hypercoagulability. Conclusions: In order to guarantee the highest quality of the laboratory services, a proper interpretation and report of the patients' results must be congruent and harmoniously associated to the actual clinical condition of the patient. Duplication of the PT determination from the same sample would exclude situations of false hypercoagulability and would provide significant improvement for the patient's safety.
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Affiliation(s)
- Carmen Delianu
- Department of Biochemistry, “Grigore T. Popa” University of Medicine and Pharmacy, 700115 Iasi, Romania; (C.D.); (A.G.); (L.F.)
- Central Clinical Laboratory—Hematology Department, “Sf. Spiridon” County Clinical Emergency Hospital, 700111 Iasi, Romania
| | - Mihaela Moscalu
- Department of Preventive Medicine and Interdisciplinarity, “Grigore T. Popa” University of Medicine and Pharmacy, 700115 Iasi, Romania
- Correspondence: (M.M.); (L.L.H.)
| | - Loredana Liliana Hurjui
- Central Clinical Laboratory—Hematology Department, “Sf. Spiridon” County Clinical Emergency Hospital, 700111 Iasi, Romania
- Department of Morpho-Functional Sciences II, Discipline of Physiology, “Grigore T. Popa” University of Medicine and Pharmacy, 700115 Iasi, Romania;
- Correspondence: (M.M.); (L.L.H.)
| | - Claudia Cristina Tărniceriu
- Department of Morpho-Functional Sciences I, Discipline of Anatomy, “Grigore T. Popa” University of Medicine and Pharmacy, Universității str. 16, 700115 Iasi, Romania;
- Hematology Clinic, “Sf. Spiridon” County Clinical Emergency Hospital, 700111 Iasi, Romania
| | - Oana-Viola Bădulescu
- Department of Morpho-Functional Sciences II, Discipline of Physiology, “Grigore T. Popa” University of Medicine and Pharmacy, 700115 Iasi, Romania;
- Hematology Clinic, “Sf. Spiridon” County Clinical Emergency Hospital, 700111 Iasi, Romania
| | - Ludmila Lozneanu
- Department of Morpho-Functional Sciences I, Discipline of Histology, “Grigore T. Popa” University of Medicine and Pharmacy, Universității str. 16, 700115 Iasi, Romania;
- Department of Pathology, “Sf. Spiridon” Emergency County Hospital, 700111 Iasi, Romania
| | - Ion Hurjui
- Department of Morpho-Functional Sciences II, Discipline of Biophysics, “Grigore T. Popa” University of Medicine and Pharmacy, 700115 Iasi, Romania;
| | - Ancuta Goriuc
- Department of Biochemistry, “Grigore T. Popa” University of Medicine and Pharmacy, 700115 Iasi, Romania; (C.D.); (A.G.); (L.F.)
| | - Zinovia Surlari
- Department of Odontology and Parodontology, “Grigore T. Popa” University of Medicine and Pharmacy, Universității str. 16, 700115 Iasi, Romania;
| | - Liliana Foia
- Department of Biochemistry, “Grigore T. Popa” University of Medicine and Pharmacy, 700115 Iasi, Romania; (C.D.); (A.G.); (L.F.)
- Central Clinical Laboratory—Biochemistry Department, “Sf. Spiridon” County Clinical Emergency Hospital, 700111 Iasi, Romania
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12
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Baker P, Platton S, Gibson C, Gray E, Jennings I, Murphy P, Laffan M. Guidelines on the laboratory aspects of assays used in haemostasis and thrombosis. Br J Haematol 2020; 191:347-362. [PMID: 32537743 DOI: 10.1111/bjh.16776] [Citation(s) in RCA: 30] [Impact Index Per Article: 7.5] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/18/2023]
Affiliation(s)
- Peter Baker
- Oxford Haemophilia and Thrombosis Centre, Oxford University Hospitals NHS Foundation Trust, Oxford, UK
| | - Sean Platton
- Haemophilia Centre, Barts Health NHS Trust, London, UK
| | - Claire Gibson
- Specialist Haemostasis, Cambridge University Hospitals NHS Foundation Trust, Cambridge, UK
| | - Elaine Gray
- Haemostasis Section, Biotherapeutics Group, National Institute for Biological Standards and Controls, Hertfordshire, UK
| | | | - Paul Murphy
- Department of Haematology, the Newcastle upon Tyne Hospitals NHS Foundation Trust, Newcastle upon Tyne, UK
| | - Mike Laffan
- Centre for Haematology, Imperial College and Hammersmith Hospital, London, UK
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13
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Gardiner C, Lane P, Langley K, Tailor H, Machin SJ, Mackie IJ. A comparative evaluation of the CN‐6000 haemostasis analyser using coagulation, amidolytic, immuno‐turbidometric and light transmission aggregometry assays. Int J Lab Hematol 2020; 42:643-649. [PMID: 32885901 PMCID: PMC9291559 DOI: 10.1111/ijlh.13271] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/26/2020] [Revised: 05/20/2020] [Accepted: 05/31/2020] [Indexed: 11/28/2022]
Abstract
Background The CN‐6000 (Sysmex Corp.) is a new haemostasis analyser with blood coagulation, amidolytic, immuno‐turbidometric and light transmission aggregometry (LTA) capabilities. Transmitted light is monitored at multiple wavelengths (340, 405, 575, 660, 800 nm), from an LED light source. Aims To evaluate the performance of the CN‐6000 against a predicate device. Methods The CN‐6000 was evaluated against the CS‐5100 (Sysmex) for 14 different tests, using 880 samples from normal subjects, anticoagulated patients, critically ill patients, plasmas with high or low fibrinogen content or abnormal levels of interfering substances. Between‐day assay imprecision was assessed using commercial QC materials (n = 10 replicates on each of 5 days). Results Acceptable levels of imprecision were obtained for all assays. Agreement between the two analysers was excellent for all assays. Throughput was 35% higher using the CN‐6000 (337 vs 250 tests per hour for PT, aPTT and fibrinogen). The CN‐6000 also demonstrated improved clot detection in plasmas with high levels of interfering substances as demonstrated by a 29% reduction in “vote‐outs” due to low light transmission (24 vs 34). Conclusions The CN‐6000 demonstrated excellent comparability with the predicate instrument and acceptable levels of imprecision in all assays. Improvements in throughput and clot detection in the presence of interfering substances were also shown.
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Affiliation(s)
- Chris Gardiner
- Haemostasis Research Unit University College London London UK
| | - Philip Lane
- Haemostasis Research Unit University College London London UK
| | - Katy Langley
- Haemostasis Research Unit University College London London UK
| | - Hitesh Tailor
- Haematology Evaluations Unit HSL (Analytics) LLP London UK
| | | | - Ian J. Mackie
- Haemostasis Research Unit University College London London UK
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14
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Hedeland Y, Gustafsson CM, Touza Z, Ridefelt P. Hemolysis interference in 10 coagulation assays on an instrument with viscosity‐based, chromogenic, and turbidimetric clot detection. Int J Lab Hematol 2020; 42:341-349. [DOI: 10.1111/ijlh.13188] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/23/2019] [Revised: 02/12/2020] [Accepted: 02/27/2020] [Indexed: 11/29/2022]
Affiliation(s)
- Ylva Hedeland
- Department of Medical Sciences Clinical Chemistry Uppsala University Hospital Uppsala Sweden
- Clinical Chemistry and Pharmacology Uppsala University Hospital Uppsala Sweden
| | | | - Zinah Touza
- Department of Medical Sciences Clinical Chemistry Uppsala University Hospital Uppsala Sweden
| | - Peter Ridefelt
- Department of Medical Sciences Clinical Chemistry Uppsala University Hospital Uppsala Sweden
- Clinical Chemistry and Pharmacology Uppsala University Hospital Uppsala Sweden
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15
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Nougier C, Jousselme E, Sobas F, Pousseur V, Négrier C. Effects of hemolysis, bilirubin, and lipemia interference on coagulation tests detected by two analytical systems. Int J Lab Hematol 2019; 42:88-94. [DOI: 10.1111/ijlh.13147] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/28/2019] [Revised: 11/07/2019] [Accepted: 11/12/2019] [Indexed: 11/28/2022]
Affiliation(s)
- Christophe Nougier
- Hospices Civils de Lyon Laboratoire d'Hématologie Centre de Biologie et Pathologie Est Bron Cedex France
| | - Emilie Jousselme
- Hospices Civils de Lyon Laboratoire d'Hématologie Centre de Biologie et Pathologie Est Bron Cedex France
| | - Frédéric Sobas
- Hospices Civils de Lyon Laboratoire d'Hématologie Centre de Biologie et Pathologie Est Bron Cedex France
| | - Valentin Pousseur
- Hospices Civils de Lyon Laboratoire d'Hématologie Centre de Biologie et Pathologie Est Bron Cedex France
| | - Claude Négrier
- Hospices Civils de Lyon Laboratoire d'Hématologie Centre de Biologie et Pathologie Est Bron Cedex France
- Hospices Civils de Lyon unité d'hémostase clinique Hôpital Louis Pradel Bron Cedex France
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16
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Zhao KN, Dimeski G, de Jersey J, Johnson LA, Grant M, Masci PP, Lavin MF. Rapid serum tube technology overcomes problems associated with use of anticoagulants. Biochem Med (Zagreb) 2019; 29:030706. [PMID: 31624459 PMCID: PMC6784418 DOI: 10.11613/bm.2019.030706] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/05/2018] [Accepted: 06/26/2019] [Indexed: 01/18/2023] Open
Abstract
Introduction Failure to obtain complete blood clotting in serum is a common laboratory problem. Our aim was to determine whether snake proth-rombin activators are effective in clotting blood and producing quality serum for analyte measurement in anticoagulated patients. Materials and methods Whole blood clotting was studied in a total of 64 blood samples (41 controls, 20 Warfarin patients, 3 anticoagulated patients using snake venom prothrombin activator (OsPA)) with plain tubes. Coagulation was analysed using a visual assay, Hyland-Clotek and thromboelastography. Healthy control blood was spiked with a range of anticoagulants to determine the effectiveness of OsPa-induced clotting. A paired analysis of a Dabigatran patient and a control investigated the effectiveness of the OsPA clotting tubes. Biochemical analytes (N = 31) were determined for 7 samples on chemistry and immunoassay analysers and compared with commercial tubes. Results Snake venom prothrombin activators efficiently coagulated blood and plasma spiked with heparin and commonly used anticoagulants. Clotting was observed in the presence of anticoagulants whereas no clotting was observed in BDRST tubes containing 3 U/mL of heparin. Snake venom prothrombin activator enhanced heparinised blood clotting by shortening substantially the clotting time and improving significantly the strength of the clot. Comparison of 31 analytes from the blood of five healthy and two anticoagulated participants gave very good agreement between the analyte concentrations determined. Conclusions Our results showed that the snake venom prothrombin activators OsPA and PtPA efficiently coagulated recalcified and fresh bloods with or without added anticoagulants. These procoagulants produced high quality serum for accurate analyte measurement.
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Affiliation(s)
- Kong-Nan Zhao
- Faculty of Medicine, University of Queensland, Translational Research Institute, Brisbane, Australia
| | - Goce Dimeski
- Chemical Pathology, Princess Alexandra Hospital, Brisbane, Australia
| | - John de Jersey
- School of Chemistry and Molecular Biosciences, University of Queensland, Brisbane, Australia
| | - Lambro A Johnson
- Faculty of Medicine, University of Queensland, Translational Research Institute, Brisbane, Australia
| | - Michael Grant
- Q-Sera Pty Ltd, Level 9,31 Queen St, Melbourne, Australia
| | - Paul P Masci
- Faculty of Medicine, University of Queensland, Translational Research Institute, Brisbane, Australia
| | - Martin F Lavin
- Faculty of Medicine, University of Queensland, Translational Research Institute, Brisbane, Australia
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17
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Hemolysis has no influence on routine coagulation tests in subjects without anticoagulant therapy - a referral Romanian emergency hospital laboratory experience. REV ROMANA MED LAB 2019. [DOI: 10.2478/rrlm-2019-0034] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
Abstract
The aim of this study was to determine the rate of hemolyzed specimens sent to our laboratory for coagulation testing, assess the interference of hemolysis on coagulation for patients without anticoagulant therapy and to determine the reference intervals for PT, INR and aPTT for our laboratory in order to test our own limitations.
Methods: To determine the hemolysis rate, 1,689 specimens were evaluated on a visual scale and with the hemolysis icterus lipemia (HYL) test on Architect c4000 instrument. 125 blood samples collected from subjects without anticoagulant therapy were hemolyzed in vitro and the PT, INR and aPTT results were compared before and after hemolysis.To determine reference intervals (RI) for PT, INR and aPTT in our population, 125 apparently healthy human subjects (according to CLSI C28-A2) were enrolled and tests were performed on Sysmex CS 2000i, using Siemens reagents.
Results: Out of 1,689 samples, 9.46% were assessed as hemolyzed by the visual scale, while HYL test showed a 6.63% hemolysis rate. We found a shortening of 0.1s for PT, a diminution with 0.01 units for INR and a prolongation with 0.9s for aPTT from in vitro hemolyzed compared to non-lyzed samples. As to the reference intervals, we obtained in our laboratory versus reagents producer: for PT 9.8-13.9 s vs 9.8-12.1 s, and for aPTT 19.1-31.5s vs 23-31.9 s respectively; 28.38% more PT results and 13.44% more aPTT results were within range when we used local laboratory RI, compared to the manufacturer’s RI.
Conclusions: The rate of hemolyzed coagulation samples in our laboratory is higher than the rate found in the literature. Nevertheless, for patients without anticoagulant therapy hemolyzed samples should be processed. Using our own reference interval leads to a significant reduced number of abnormal results.
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18
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Storti S, Battipaglia E, Parri MS, Ripoli A, Lombardi S, Andreani G. Pre-analytical quality control in hemostasis laboratories: visual evaluation of hemolysis index alone may cause unnecessary sample rejection. J LAB MED 2019. [DOI: 10.1515/labmed-2018-0122] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
Abstract
Background
Visual inspection is the most widespread method for evaluating sample hemolysis in hemostasis laboratories. The hemolysis index (HI) was determined visually (visual index, VI) and measured on an ACL TOP 750 (IL Werfen) system with a hemolysis-icterus-lipemia index (HIL) module. These values were compared with those measured on clinical chemistry systems Unicel DXC600 and AU680 and with quantitation of free-hemoglobin (Hb) performed by a spectrophotometric measurement method (SMM).
Methods
The HI was measured in 356 sodium citrate plasma samples, 306 of which were visibly hemolyzed to varying degrees and 50 were not hemolyzed. The analytical performance of each method was evaluated.
Results
Linear regression analysis, calculated between SMM and the other systems in the study, returned coefficients of determination r2 = 0.853 (AU680), r2 = 0.893 (DXC600) and r2 = 0.917 (ACL TOP 750). An r2 = 0.648 was obtained for linear regression analysis between VI and ACL TOP 750. In addition, ACL TOP 750 showed an excellent correlation in multivariate analysis (r2 = 0.958), showing good sensitivity (0.939) and specificity (0.934) and a diagnostic accuracy of 94%. By comparison, DXC600 and AU680 showed coefficients of determination of 0.945 and 0.923, respectively. A cut-off was set at 0.15 g/L free-Hb, as determined by the automated method, such that any hemostasis samples measuring above this threshold should not be analyzed. Based on this criterion, samples were classified as accepted or rejected, and the number of samples discarded during VI or ACL TOP 750 measurements was compared.
Conclusions
This study confirmed that hemostasis laboratories should consider introducing an objective, automated and standardized method to check samples for hemolysis. By relying solely on visual inspection, up to 50% of samples could be unnecessarily rejected. The ACL TOP 750 system demonstrated a satisfactory analytical performance, giving results comparable to those of the reference method.
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19
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Evrard J, Siriez R, Morimont L, Thémans P, Laloy J, Bouvy C, Gheldof D, Mullier F, Dogné J, Douxfils J. Optimal wavelength for the clot waveform analysis: Determination of the best resolution with minimal interference of the reagents. Int J Lab Hematol 2019; 41:316-324. [DOI: 10.1111/ijlh.12975] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/12/2018] [Revised: 12/19/2018] [Accepted: 01/04/2019] [Indexed: 01/10/2023]
Affiliation(s)
- Jonathan Evrard
- Department of Pharmacy, Namur Thrombosis and Hemostasis Center (NTHC), Namur Research Institute for Life Sciences (NARILIS) University of Namur Namur Belgium
| | - Romain Siriez
- Department of Pharmacy, Namur Thrombosis and Hemostasis Center (NTHC), Namur Research Institute for Life Sciences (NARILIS) University of Namur Namur Belgium
| | - Laure Morimont
- Department of Pharmacy, Namur Thrombosis and Hemostasis Center (NTHC), Namur Research Institute for Life Sciences (NARILIS) University of Namur Namur Belgium
| | - Pauline Thémans
- Department of Mathematics, Namur Institute for Complex System (naXys) University of Namur Namur Belgium
| | - Julie Laloy
- Department of Pharmacy, Namur Nanosafety Center (NNC), Namur Research Institute for Life Sciences (NARILIS) University of Namur Namur Belgium
| | | | | | - François Mullier
- CHU UCL Namur, Hematology Laboratory, Namur Thrombosis and Hemostasis Center (NTHC), Namur Research Institute for Life Sciences (NARILIS) Université Catholique de Louvain Yvoir Belgium
| | - Jean‐Michel Dogné
- Department of Pharmacy, Namur Thrombosis and Hemostasis Center (NTHC), Namur Research Institute for Life Sciences (NARILIS) University of Namur Namur Belgium
| | - Jonathan Douxfils
- Department of Pharmacy, Namur Thrombosis and Hemostasis Center (NTHC), Namur Research Institute for Life Sciences (NARILIS) University of Namur Namur Belgium
- Qualiblood s.a. Namur Belgium
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