Assessment of Changes in Coagulation in Parturients with Preeclampsia Using Thromboelastography 

1999 ◽  
Vol 90 (2) ◽  
pp. 385-390 ◽  
Author(s):  
Shiv K. Sharma ◽  
John Philip ◽  
Charles W. Whitten ◽  
Udaya B. Padakandla ◽  
Dennis F. Landers
Keyword(s):  
Platelet Count ◽  
Pregnant Women ◽  
Whole Blood ◽  
Maximum Amplitude ◽  
Study Groups ◽  
Coagulation Profile ◽  
Coagulation Tests ◽  
Active Labor ◽  
Coagulation Defects ◽  
Disposable Plastic

Background Preeclampsia is associated with a risk of abnormal hemostasis that occurs most commonly secondary to thrombocytopenia. Thromboelastography measures whole blood coagulation and has been used to manage coagulation defects in obstetric patients. The authors conducted this investigation in a large number of preeclamptic women to assess changes in coagulation using thromboelastography. Methods Thromboelastography and platelet counts were performed in 52 healthy pregnant women, 140 mild preeclamptic women, and 114 severe preeclamptic women in active labor using disposable plastic cups and pins and native whole blood. In preeclamptic patients with a platelet count <100,000/mm3, conventional coagulation tests were also performed. Epidural analgesia was provided in some women when they requested pain relief. Results Fifteen percent of all preeclamptic women (38 of 254) and 2% (1 of 52) of healthy pregnant women had a platelet count <100,000/mm3. The incidence of thrombocytopenia <100,000/mm3 was 3% (4 of 140) and 30% (34 of 114) in mild preeclamptic patients and severe preeclamptic patients, respectively. Severe preeclamptic patients with a platelet count <100,000/mm3 were significantly hypocoagulable when compared to the other study groups. Ten severe preeclamptic women with a platelet count <100,000/mm3 had a maximum amplitude <54 mm (the lower limit of maximum amplitude in healthy pregnant women enrolled in this investigation). None of the mild preeclamptic women had a maximum amplitude <54 mm. Five severe preeclamptic women with a platelet count <100,000/mm3 had an abnormal coagulation profile, whereas all four mild preeclamptic women with a platelet count <100,000/mm3 had a normal coagulation profile. Conclusion This study shows that severe preeclamptic women with a platelet count <100,000/mm3 are hypocoagulable when compared to healthy pregnant women and other preeclamptic women.

scholarly journals The Sonoclot: A New Thrombokinetic Coagulation Instrument

1977 ◽  
Author(s):  
R.D. Hamstra ◽  
G.E. Ens ◽  
S. Simons
Keyword(s):  
Whole Blood ◽  
Blood Clotting ◽  
Formation Rate ◽  
Severe Bleeding ◽  
Axial Vibration ◽  
Clotting Time ◽  
Activated Clotting Time ◽  
Coagulation Tests ◽  
Disposable Plastic ◽  
Normal Adults

A new coagulation instrument (Sonoclot) has been evaluated in the laboratory, at the bedside, and in surgery. It was compared to the prothrombin time, activated partial thromboplastin time, activated clotting time, Lee-White clotting time, fibrinogen and thrombelastograph. Most coagulation tests are reported as time to a clot end point while the Sonoclot records a continuous thrombokinetic pattern by measuring the energy required to maintain axial vibration of a hollow plastic probe in 0.4 ml of whole blood while it clots. Disposable plastic probes and non-siliconized glass cuvettes are rapidly changed after testing. Results are a line pattern which has been analysed for Clot Onset (C0) and Clot Formation Rate (CFR). Native whole blood from normal adults (54 studied) has a C0 of 2-4.5 minutes and CFR of 4-8 chart units/minute. The only similar clotting instrument is the thrombelastograph (TEG). Sonoclot and TEG patterns correlate, the Sonoclot sensing change before the TEG. Whole blood clotting measured with the Sonoclot is a new method which distinguishes hypercoagulation, various levels of heparin, and severe bleeding problems from normal. The device is durable, stable, easy to operate, and portable, providing a permanent record in a few minutes.

The Relationship between the Results of Coagulation Profile and Severity of Pulmonary Involvement in COVID-19 Patients

2021 ◽  
Author(s):  
Mohsen Ebrahimi ◽  
Samaneh Abiri ◽  
Esmaeal Rayat Dost ◽  
Fatemeh Rahmanian ◽  
Mahdi Foroughian ◽  
...  
Keyword(s):  
Platelet Count ◽  
Pulmonary Involvement ◽  
Cross Sectional Study ◽  
High Resolution Computed Tomography ◽  
Cross Sectional ◽  
Coagulation Profile ◽  
Discriminating Power ◽  
Global Pandemic ◽  
Coagulation Tests ◽  
Severe Group

ntroduction: COVID-19 is currently a global pandemic, and coagulation-related mortality has been widely reported in patients suffering from it. Objective: this article aimed to investigate the coagulation profile of COVID-19 patients. Methods: This was a cross-sectional study conducted using a retrospective research design. We recruited patients with COVID-19 admitted to a hospital from June 15th to July 7th, 2020. Upon patients’ entering a blood sample was drawn from each patient for assessing patient’s coagulation profile (PT, PTT, INR, Platelet count); and a chest high-resolution computed tomography (HRCT) scan was performed for each patient. The study patients were divided in to sever group (CO-RADS score 5) and non-sever group (CO-RADS score <5). Results: Thirty-six patients (20 males and 16 females) with a mean age of 54.7±17.5 years were studied. Of them, 11 cases (30.56%) had severe pulmonary involvement. Also, the coagulation profiles were longer in the severe group than non-sever group. As well, the means of platelet count that were 232.440 per microliter in the non-severe group and 289.180 per microliter in the severe and non-sever groups, respectively; but still not statistically significant (p>0.05). The Area under the ROC Curve (AUC) for PT and INR was 0.615 and 0.611, respectively. The AUC for platelet count was 0.680 (95% CI: 0.501 to 0.859) and had an acceptable discriminating power. Conclusions: In this study, we did not find any statistically significant relationship between the results of coagulation tests and the severity of pulmonary involvement according to HRCT scan findings in COVID-19 patients. But further analyses suggest that, except PTT, the other coagulation tests (PT, INR, and platelet count) may discriminate severe COVID-19 patients.

The Effect of Platelet -, and Leukocyte Count on the Thrombelastograph® (TEG) Parameters.

Blood ◽  
2004 ◽  
Vol 104 (11) ◽  
pp. 3971-3971
Author(s):  
W.W.H. Roeloffzen ◽  
J.C. Kluin-Nelemans ◽  
Joost de Wolf
Keyword(s):  
Platelet Count ◽  
Point Of Care ◽  
Maximum Amplitude ◽  
Multiple Regression Model ◽  
Clot Strength ◽  
Normal Limits ◽  
Coagulation Tests ◽  
Plasmatic Coagulation ◽  
Sensitivity Specificity ◽  
Normal Controls

Abstract Background. The TEG is used in situations were point of care testing of hemostasis is desired, although its value is still controversially because of insufficient test validation. The main parameters of the TEG are (a) the reaction time (R), the time until the initial fibrin formation and comparable with the coagulation times PT and APTT; (b) clotting time (K), the time until a fixed level of clot firmness is reached; (c) the angle (α) is closely related to K and measures the rapidity of fibrin build up and gives information about the clot strength; R, K and α are prolonged by anticoagulants and factor deficiencies; (d) maximum amplitude (MA) is a measurement of maximum strength or stiffness of the developed clot; it is especially influenced by platelets and fibrin. Methods. We performed a multivariate analysis using the Cox multiple-regression model to study the effects of Leukocytes, Hb, and platelet count on the TEG parameters. Results. Ninety native whole blood samples from 19 patients undergoing consolidation chemotherapy were studied; in the post chemotherapy phase in which platelets decreased from normal to < 10 x 109/l samples were taken; in all these cases PT, APTT and Fibrinogen were within normal limits. Platelets significantly influenced all parameters: R (p<0.001, r=−0.5), K (p<0.001, r=−0.7), α (p<0.001, r=+0.7), MA (p<0.001, r=+0.6) whereas Leukocytes influenced MA as well (p<0.001, r=0.3). In normal controls K is 9 ± 3 min (n=110), in patients with platelet count 50–100, 25–50 and <25 x 109/l K was resp. 17 ± 9, 30 ± 13 and 46 ± 10 min. In normal controls MA was 46 ± 7 mm, in patients MA became significant smaller with platelets < 25 x 109/l: 30 ± 5 mm. In patients with leukocytes ranging from 0–0.1, 0.1–1.0, 1.0–3.5 and > 3.5 x 109/l the MA was resp. 44 ± 14, 49 ± 15, 54 ± 9, and 58 ± 8 mm. As the MA is considered the parameter most influenced by platelet count, we calculated the sensitivity, specificity, pos and neg predictive value of MA to detect a platelet count less then 50 x 109/l, they were resp. 35%, 100%, 100% and 73%. Conclusion. Firstly, platelet count not only influences MA but also the coagulation parameters R, K and α; besides leukocytes influences the clot strength; this is in agreement with the new conceptual cell based model of hemostasis; secondly, the TEG should be considered as additive to platelet count and plasmatic coagulation tests and not as a replacement.

scholarly journals CTAD as a universal anticoagulant

2003 ◽  
Vol 25 (1) ◽  
pp. 17-20 ◽  
Author(s):  
M. Yokota ◽  
N. Tatsumi ◽  
I. Tsuda ◽  
T. Nishioka ◽  
T. Takubo
Keyword(s):  
Platelet Count ◽  
Whole Blood ◽  
Partial Thromboplastin Time ◽  
Mean Platelet Volume ◽  
Blood Count ◽  
Complete Blood Count ◽  
Activated Partial Thromboplastin Time ◽  
Medical Laboratory ◽  
Platelet Volume ◽  
Coagulation Tests

The feasibility of CTAD (a mixture of citrate, theophylline, adenosine and dipyridamole) as a new anticoagulant for medical laboratory use was studied prospectively. Whole blood anticoagulated with CTAD exhibited results very similar to those of blood anticoagulated with EDTA on complete blood count and automated white cell differential except for a slight decrease in platelet count and mean platelet volume. Chemistry test data for plasma obtained from CTAD whole blood were close to those obtained for matched sera. Among coagulation tests, prothrombin time, activated partial thromboplastin time and fibrinogen concentrations were close to those obtained with citrate plasma. Based on the results, CTAD was judged to be a good candidate as a new anticoagulant.

Coagulation Profile in Liver Diseases: A Study of 300 Cases in a Tertiary Care Hospital in Uttarakhand, India

2017 ◽  
Vol 2 (2) ◽  
pp. 61-64
Author(s):  
Sanjeev Kishore ◽  
Gautam Bhatia ◽  
Sanjay Kaushik ◽  
Rajnish Kumar ◽  
Umesh Bhatia
Keyword(s):  
Platelet Count ◽  
Liver Diseases ◽  
Tertiary Care Hospital ◽  
Tertiary Care ◽  
Coagulation Cascade ◽  
Care Hospital ◽  
Coagulation Profile ◽  
Coagulation Abnormalities ◽  
Increased Risk ◽  
Coagulation Tests

ABSTRACT Background The liver is the cornerstone of the coagulation system. The physiology of blood coagulation is closely linked to liver function as the liver synthesizes most of the factors of the coagulation cascade and fibrinolytic proteins. Objective The objective of this study was to evaluate coagulation abnormalities associated with chronic liver diseases and determine the coagulation abnormalities using various coagulation studies [prothrombin time (PT), activated partial thromboplastin time (APTT), bleeding time (BT), clotting time (CT), and platelet count]. Materials and methods This study included 300 patients clinically diagnosed with liver disease and who were divided into three categories – cirrhosis, hepatitis, and other liver diseases. The coagulation tests PT, APTT, BT, CT, and platelet count were performed and the results were evaluated in groups. Results Out of the 300 patients, 156 were diagnosed with cirrhosis, 75 were of viral hepatitis, and 69 were of other liver diseases. About 62% (186/300) had prolonged PT. About 39.3% (118/300) had prolonged APTT. The BT was prolonged in 34% (102/300), while CT was prolonged in 10.6% (32/300). Thrombocytopenia was seen in 46% (138/300) patients. Conclusion We concluded that various abnormalities of coagulation tests vary greatly with different liver disorders, duration of the disorders, and their severity. Prolongation of PT and APTT in advancing liver cirrhosis indicates damage to the liver parenchyma resulting in decreased production of coagulation proteins with increased risk of bleeding tendencies, which can be detected before these ensue. How to cite this article Bhatia G, Kaushik S, Kumar R, Kishore S, Bhatia U. Coagulation Profile in Liver Diseases: A Study of 300 Cases in a Tertiary Care Hospital in Uttarakhand, India. Int J Adv Integ Med Sci 2017;2(2):61-64.

Macroaggregation of Platelets in Plasma, as Distinct from Microaggregation in Whole Blood (and Plasma), as Determined Using Optical Aggregometry and Platelet Counting respectively, is Specifically Impaired following Cardiopulmonary Bypass in Man

1994 ◽  
Vol 72 (04) ◽  
pp. 511-518 ◽  
Author(s):  
Valentine C Menys ◽  
Philip R Belcher ◽  
Mark I M Noble ◽  
Rhys D Evans ◽  
George E Drossos ◽  
...  
Keyword(s):  
Cardiac Surgery ◽  
Platelet Count ◽  
Cardiopulmonary Bypass ◽  
Whole Blood ◽  
Platelet Rich Plasma ◽  
Interquartile Range ◽  
Contributory Factor ◽  
Platelet Aggregability ◽  
Aggregate Growth

SummaryWe determined changes in platelet aggregability following cardiopulmonary bypass, using optical aggregometry to assess macroaggregation in platelet-rich plasma (PRP), and platelet counting to assess microaggregation both in whole blood and PRP. Hirudin was used as the anticoagulant to maintain normocalcaemia.Microaggregation (%, median and interquartile range) in blood stirred with collagen (0.6 µg/ml) was only marginally impaired following bypass (91 [88, 93] at 10 min postbypass v 95 (92, 96] prebypass; n = 22), whereas macroaggregation (amplitude of response; cm) in PRP stirred with collagen (1.0µg/ml) was markedly impaired (9.5 [8.0, 10.8], n = 41 v 13.4 [12.7,14.3], n = 10; p <0.0001). However, in PRP, despite impairment of macroaggregation (9.1 [8.5, 10.1], n = 12), microaggregation was near-maximal (93 [91, 94]), as in whole blood stirred with collagen. In contrast, in aspirin-treated patients (n = 14), both collagen-induced microaggregation in whole blood (49 [47, 52]) and macroaggregation in PRP (5.1 [3.8, 6.6]) were more markedly impaired, compared with control (both p <0.001).Similarly, in PRP, macroaggregation with ristocetin (1.5 mg/ml) was also impaired following bypass (9.4 [7.2, 10.7], n = 38 v 12.4 [10.0, 13.4]; p <0.0002, n = 20), but as found with collagen, despite impairment of macroaggregation (7.2 [3.5,10.9], n = 12), microaggregation was again near-maximal (96 [93,97]). The response to ristocetin was more markedly impared after bypass in succinylated gelatin (Gelo-fusine) treated patients (5.6 [2.8, 8.6], n = 17; p <0.005 v control), whereas the response to collagen was little different (9.3 v 9.5). In contrast to findings with collagen in aspirin-treated patients, the response to ristocetin was little different to that in controls (8.0 v 8.3). Impairment of macroaggregation with collagen or ristocetin did not correlate with the duration of bypass or the platelet count, indicating that haemodilution is not a contributory factor.In conclusion: (1) Macroaggregation in PRP, as determined using optical aggregometry, is specifically impaired following bypass, and this probably reflects impairment of the build-up of small aggregates into larger aggregates. (2) Impairment of aggregate growth and consolidation could contribute to the haemostatic defect following cardiac surgery.

A Simple and Rapid Method to Determine GPIIb/IIIa-Receptor Inhibitor Activity in Whole Blood

1999 ◽  
Vol 19 (03) ◽  
pp. 134-138
Author(s):  
Gitta Kühnel ◽  
A. C. Matzdorff
Keyword(s):  
Flow Cytometry ◽  
Platelet Count ◽  
Blood Sample ◽  
Platelet Activation ◽  
Whole Blood ◽  
Receptor Occupancy ◽  
Aggregate Formation ◽  
Inhibitor Activity ◽  
Receptor Inhibitor

SummaryWe studied the effect of GPIIb/IIIa-inhibitors on platelet activation with flow cytometry in vitro. Citrated whole blood was incubated with increasing concentrations of three different GPIIb/IIIa-inhibitors (c7E3, DMP728, XJ757), then thrombin or ADP were added and after 1 min the sample was fixed. Samples without c7E3 but with 0.1 U/ml thrombin had a decrease in platelet count. Samples with increasing concentrations of c7E3 had a lesser or no decrease in platelet count. The two other inhibitors (DMP 725, XJ757) gave similar results. GPIIb/IIIa-inhibitors prevent aggregate formation and more single platelets remain in the blood sample. The agonist-induced decrease in platelet count correlates closely with the concentration of the GPIIb/IIIa inhibitor and receptor occupancy. This correlation may be used as a simple measure for inhibitor activity in whole blood.

ASSESSMENT OF THE PLATELET COUNT IN THE PREGNANT WOMEN IN IGIMS, PATNA, BIHAR

2020 ◽  
Vol 4 (2) ◽  
Author(s):  
Tanwi Singh ◽  
Anshuman Sinha
Keyword(s):  
Platelet Count ◽  
Pregnant Women ◽  
Screening Test ◽  
Low Cost ◽  
Medical Science ◽  
Cost Effective ◽  
Platelet Indices ◽  
Increased Risk ◽  
Low Platelet Count ◽  
Severity Of The Disease

The major risk associated with low platelet count in pregnancy is the increased risk of bleeding during the childbirth or post that. There is an increased blood supply to the uterus during pregnancy and the surgical procedure requires cutting of major blood vessels. Women with thrombocytopenia are at increased risk of losing excessive blood. The risk is more in case of caesarean delivery as compared to vaginal delivery. Hence based on above findings the present study was planned for Assessment of the Platelet Count in the Pregnant Women in IGIMS, Patna, Bihar. The present study was planned in Department of Pathology, Indira Gandhi Institute of Medical Science, Patna, Bihar, India. The present study was planned from duration of January 2019 to June 2019. In the present study 200 pregnant females samples received for the platelet estimation were enrolled in the present study. Clinically platelet indices can be a useful screening test for early identification of preeclampsia and eclampsia. Also platelet indices can assess the prognosis of this disease in pregnant women and can be used as an effective prognostic marker because it correlates with severity of the disease. Platelet count is a simple, low cost, and rapid routine screening test. Hence the data generated from the present study concludes that platelet count can be used as a simple and cost effective tool to monitor the progression of preeclampsia, thereby preventing complications to develop during the gestational period. Keywords: Platelet Count, Pregnant Women, IGIMS, Patna, Bihar, etc.

STUDI GAMBARAN HASIL PEMERIKSAAN APUSAN DARAH TEPI PADA IBU HAMIL DI LABORATORIUM RSUD H.A.SULTHAN DAENG RADJA KABUPATEN BULUKUMBA

2018 ◽  
Vol 3 (2) ◽  
pp. 13-26
Author(s):  
Rahmat Aryandi ◽  
Subakhir Salnus
Keyword(s):  
Platelet Count ◽  
Pregnant Women ◽  
Blood Smear ◽  
Leukocyte Count ◽  
Marked Change ◽  
Peripheral Blood Smear ◽  
Morphological Examination ◽  
Laboratory Observation ◽  
Hematologic Disorder ◽  
Normal Platelet

During pregnancy, there will be a marked change in anatomy, physiology and biochemistry since the onset of pregnancy and often lackof nutrient intake. Hematologic disorder is often found in pregnant women because it causes pregnant women more susceptible to disturbances in blood circulation, The purpose of this study to determine the description of blood smear results in pregnant women in the laboratory RSUD H.A.Sulthan Daeng Radja District. This research is descriptive with laboratory observation approach. The sample used in this study were 30 samples of pregnant women who checked themselves in the Laboratory of RSUDH.A.Sulthan Daeng Radka Bulukumba District. The result of this research showed the result of peripheral blood smear on the morphology of erythrocytes using 30 samples of pregnant women showed 14 samples (46,66%) normocytic normochrom and the remaining 16 samples were morphological variation (53,33%), on morphological examination and platelet count with using 30 samples of pregnant women showed each 29 samples had morphology and normal platelet counts with respectively 96.66% percentage and platelet aggregation and decreased platelet count (thrombocytopenia) with each persentase 3.33%. At leukocyte morphology examination using 30 samples of pregnant women showed 29 samples had normal morphology with 96,66% percentage and one sample with hypersegmentation with percentage 3,33%. normal leukocyte count at 9 samples with percentage 30% and leukocyte count increased at 21 samples with percentage 70%.

THE EFFECT OF EARLY BLOOD TRANSFUSION ON THE OUTCOME OF GASTROINTESTINAL HAEMORRHAGE

1987 ◽  
Author(s):  
S D Blair ◽  
S B Javanvrin ◽  
C N McCollum ◽  
R M Greenhalgh
Keyword(s):  
Blood Transfusion ◽  
Blood Coagulation ◽  
Whole Blood ◽  
Randomised Trial ◽  
Gastrointestinal Haemorrhage ◽  
Clotting Time ◽  
Prospective Randomised Trial ◽  
Coagulation Tests ◽  
To Receive ◽  
Upper Gastrointestinal

It has been suggested that mortality due to upper gastrointestinal haemorrhage may be reduced by restricting blood transfusion [1], We have assessed whether this is due to an anticoagulant effect in a prospective randomised trial.One hundred patients with severe, acute gastrointestinal haemorrhage were randomised to receive either at least 2 units of blood during the first 24 hours of admission, or no blood unless their haemaglobin was lessthan 8g/dl or they were shocked. Minor bleeds and varices were excluded As hypercoagulation cannot be measured using conventional coagulation tests, fresh whole blood coagulation was measured by the Biobridge Impedance Clotting Time (ICT). Coagulation was assessed at 24 hour intervals and compared to age matched controls with the results expressed as mean ± sem.The ICT on admission for the transfusion group (n=50) was 3.2±0.2 mins compared to 10±0.2 mins in controls. This hyper-coagulable state was partially reversed to 6.4±0.3 mins at 24 hours (p<0.001). The 50 allocated to receive no blood had a similar ICT on admission of 4.4±0.4 mins but the hypercoagulable state was maintained with ICT at 24 hours of 4.320.4 mins. Only 2 patients not transfused rebled compared to 15 in the early transfusion group (p<0.001). Five patients died, and they were all in the early transfusion group.These findings show there is a hypercoagulable response to haemorrhage which is partially reversed by blood transfusion leading to rebleeding

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