Masking of heparin activity in the activated coagulation time (ACT) by platelet procoagulant activity

1994 ◽  
Vol 73 (5) ◽  
pp. 285-300 ◽  
Author(s):  
Arthur P. Bode ◽  
Robert M. Lust
Keyword(s):  
Procoagulant Activity ◽  
Coagulation Time ◽  
Heparin Activity ◽  
Activated Coagulation Time

The Effect of Lysed Platelets on Neutralization of Heparin In Vitro with Protamine as Measured by the Activated Coagulation Time (ACT)

1991 ◽  
Vol 66 (02) ◽  
pp. 213-217 ◽  
Author(s):  
Arthur P Bode ◽  
William J Castellani ◽  
Edna D Hodges ◽  
Susan Yelverton
Keyword(s):  
Platelet Rich Plasma ◽  
Coagulation Time ◽  
Platelet Factor ◽  
Platelet Suspension ◽  
Antiheparin Activity ◽  
Unit Increase ◽  
Heparin Anticoagulation ◽  
Heparin Activity ◽  
Activated Coagulation Time

SummaryThe effect of lysed platelets on the activated coagulation time (ACT) was studied in heparinized whole blood during titration with protamine. Frozen-thawed washed platelet suspension, or a chromatography fraction thereof, or autologous frozen-thawed platelet-rich plasma was added in various dilutions to freshly drawn blood anticoagulated with 3,000 USP units/1 heparin. After a 10 min incubation, the amount of protamine needed to restore the ACT to baseline ("protamine titration dose") was determined. We found that the protamine titration dose decreased in proportion to the amount of lysed platelet material added; expressed as a percentage of the total number of platelets present, each unit increase in lysed platelets produced a 1.7% ±0.8 (SD) reduction in the protamine dose needed to normalize the ACT. A heparin activity assay showed that this effect was not due to antiheparin activity of lysed platelets such as platelet factor 4 (PF4). Our data indicate that the procoagulant activity of platelet membranes reduced the sensitivity of the ACT to heparin. These findings suggest that membranous platelet microparticles may cause an inaccurate calculation, based on the ACT, of a protamine dose to reverse heparin anticoagulation in cardiopulmonary bypass procedures.

Anticoagulation Monitoring Under ECMO Support: A Comparative Study Between the Activated Coagulation Time and the Anti-Xa Activity Assay

2018 ◽  
Vol 35 (7) ◽  
pp. 679-686 ◽  
Author(s):  
Clément Delmas ◽  
Aemilia Jacquemin ◽  
Fanny Vardon-Bounes ◽  
Bernard Georges ◽  
Felipe Guerrero ◽  
...  
Keyword(s):  
Anticoagulation Therapy ◽  
Target Range ◽  
Clotting Time ◽  
Coagulation Time ◽  
Empirically Supported ◽  
Activated Clotting Time ◽  
Heparin Activity ◽  
Venovenous Ecmo ◽  
Activated Coagulation Time ◽  
Heparin Dosage

Purpose: Extra Corporeal Membrane Oxygenation (ECMO) is used in cases of severe respiratory and/or circulatory failure over periods of several days to several weeks. Its circuitry requires a closely monitored anticoagulation therapy that is empirically supported by activated clotting time (ACT)—a method often associated with large inter- and intraindividual variability. We aimed to compare the measurement of heparin activity with ACT and the direct measurement of the heparin activity (anti-Xa) in a large ECMO population. Methods: All patients treated by venoarterial or venovenous ECMO in our intensive care unit between January 2014 and December 2015 were prospectively included. A concomitant measurement of the anti-Xa activity and ACT was performed on the same sample collected twice a day (morning–evening) for unfractionated heparin adaptation with an ACT target range of 180 to 220 seconds. Results: One hundred and nine patients (men 69.7%, median age 54 years) treated with ECMO (70.6% venoarterial) were included. Spearman analysis found no correlation between anti-Xa and ACT (ρ < 0.4) from day 1 and worsened over time. Kappa analysis showed no agreement between the respective target ranges of ACT and anti-Xa. Conclusions: We demonstrate that concomitant measurement of ACT and anti-Xa activity is irrelevant in ECMO patients. Since ACT is poorly correlated with heparin dosage, anti-Xa activity appears to be a more suitable assay for anticoagulation monitoring.

Activated Coagulation Time (ACT) and Safety of Endovascular Sheath Removal lmportance of Senpling Site.

1991 ◽  
Vol 26 (12) ◽  
pp. 1141
Author(s):  
D. S Sallee ◽  
C. J Becker ◽  
O Bouds ◽  
J Benenati ◽  
C Zemel ◽  
...  
Keyword(s):  
Coagulation Time ◽  
Activated Coagulation Time

In Vivo Protamine Titration Using Activated Coagulation Time to Neutralize Heparin Anticoagulation in Cardiac Surgery: Proof of Concept

2020 ◽  
Vol 34 (9) ◽  
pp. 2369-2374
Author(s):  
Antoine G. Rochon ◽  
Sylvain Bélisle ◽  
Pierre Couture ◽  
Annik Fortier ◽  
Jean-Sébastien Lebon ◽  
...  
Keyword(s):  
Cardiac Surgery ◽  
Proof Of Concept ◽  
Coagulation Time ◽  
Heparin Anticoagulation ◽  
Activated Coagulation Time

scholarly journals Evaluation Procoagulant Activity and Mechanism of Astragalin

Molecules ◽  
2020 ◽  
Vol 25 (1) ◽  
pp. 177 ◽  
Author(s):  
Changqin Li ◽  
Miyun Hu ◽  
Shengjun Jiang ◽  
Zhenhua Liang ◽  
Jinmei Wang ◽  
...  
Keyword(s):  
Plasma Viscosity ◽  
Procoagulant Activity ◽  
Coagulation System ◽  
Control Group ◽  
Thrombin Time ◽  
Coagulation Time ◽  
Erythrocyte Sedimentation ◽  
Procoagulant Effect

Astragalin, isolated from flowers of Rosa chinensis Jacq., is a kind of flavonoid, with anti-inflammatory, antioxidant, antiviral, analgesic, antibacterial, antiallergic, and antihepatotoxic effects. However, no studieson the procoagulant effect of astragalin have been reported. This study aimed to investigate the procoagulant activity of astragalin and its mechanism. Its procoagulant effect was investigated by activated partial thromboplastin time (APTT), thrombin time (TT), prothrombin time (PT), and fibrinogen (FIB) in vitro, and a rat model established by heparin sodium was used to evaluate the mechanism for the procoagulant effect in vivo. The results showed that astragalin had good procoagulant effects compared with the control group in vitro. Compared with the model group in vivo, astragalin could shorten the coagulation time and significantly increase the number of platelets. Meanwhile, astragalin could significantly reduce the effectual time of PT and APTT and increase the content of FIB. The contents of 6-keto-PGF1α and eNOS significantly decreased. Astragalin could increase whole blood viscosity (WBV), plasma viscosity (PV), erythrocyte sedimentation rate (ESR) and packedcell volume (PCV). All of the above revealed that astragalin had good procoagulant effects by promoting the intrinsic and extrinsic coagulation system.

Intraoperative Detection of Traumatic Coagulopathy Using the Activated Coagulation Time

Shock ◽  
2003 ◽  
Vol 19 (5) ◽  
pp. 404-407 ◽  
Author(s):  
John A. Aucar ◽  
Peter Norman ◽  
Elizabeth Whitten ◽  
Thomas S. Granchi ◽  
Kathleen R. Liscum ◽  
...  
Keyword(s):  
Coagulation Time ◽  
Intraoperative Detection ◽  
Activated Coagulation Time ◽  
Traumatic Coagulopathy

Lactadherin as a Probe for Phosphatidylserine Exposure and as An Anticoagulant for the Procoagulant Activity in the Study of Stored Platelets.

Blood ◽  
2009 ◽  
Vol 114 (22) ◽  
pp. 3150-3150
Author(s):  
Jin Zhou ◽  
Jinxiao Hou ◽  
Wen Li ◽  
Xiaoqian Zhang ◽  
Yueyue Fu ◽  
...  
Keyword(s):  
Flow Cytometry ◽  
Confocal Microscopy ◽  
Conflicts Of Interest ◽  
Annexin V ◽  
Progressive Increase ◽  
Procoagulant Activity ◽  
Platelet Concentrates ◽  
Time Analysis ◽  
Coagulation Time ◽  
Enzymatic Assays

Abstract Abstract 3150 Poster Board III-87 Background Phosphatidylserine (PS) can support coagulant reactions. However, it is uncertain how the location and extent of PS exposure to the membranes of stored platelets affect such reactions. We compared annexin V with lactadherin as a way of detecting how of PS exposure influences the procoagulant properties of stored platelets in platelet concentrates (PCs). Method PS exposure and the relevant procoagulant activity (PCA) of platelets in 5 different PCs were investigated by flow cytometry, confocal microscopy, coagulation time analysis and enzymatic assays. PS exposure was separately measured using annexin V and lactadherin, respectively. Results Exposure of PS to stored platelets promoted thrombin formation. A progressive increase in PS exposure was detected by flow cytometry. Moreover, using lactadherin, we identifed higher levels of PS exposure on the platelets and platelet-derived microparticles (PMPs) compared to detection using annexin V. The percentage of PS-positive cells was 0.02 % by annexin V versus 0.3 % by lactadherin on day 0, 7.5 % by annexin V versus 12.3 % by lactadherin on day 5, and 29 % by annexin V versus 44.3 % by lactadherin on day 9. Rare microparticles (MPs) were released from fresh platelets, and, the number of PMPs increased approximately 2-fold on day 5 and further progressively increased. Using lactadherin and platelets in the earlier stage of storage, confocal microscopy revealed earlier and localized PS exposure based on plasma membrane staining. For later storage platelets, increased levels of PS-positive platelets and PMPs were clearly detected by both annexin V and lactadherin. Thirty-two nM lactadherin or annexin V prolonged coagulation time 2.4 fold versus 2 fold. The productions of thrombin and intrinsic/extrinsic factor Xase were approximately inhibited 85 % and 60 % by lactadherin and annexin V, respectively. Conclusion PS exposure was localized to the cellular rims, blebbing vesicles and thin elongated filopodia-like areas on banked platelets. Furthermore, lactadherin provides a more accurate measurement of PS exposure and the relevant with PCA, which is an important factor to consider for transfusion medicine. Our findings of elevated PS-positive platelets and PMPs indicate that platelets should not be stored for extended periods of time. Disclosures No relevant conflicts of interest to declare.

The Effects of Thrombocytopenia on the Activated Coagulation Time

1996 ◽  
Vol 83 (6) ◽  
pp. 1185-1188 ◽  
Author(s):  
Tameshwar Ammar ◽  
Cherie F. Fisher ◽  
Kaya Sarier ◽  
Barry S. Coller
Keyword(s):  
Coagulation Time ◽  
Activated Coagulation Time
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