The effects of dry ice exposure on plasma pH and coagulation analyses

2017 ◽  
Vol 56 (1) ◽  
Author(s):  
Lene Trondsetås ◽  
Gustav Mikkelsen ◽  
Ingrid Alsos Lian
Keyword(s):  
Partial Thromboplastin Time ◽  
Protein C ◽  
Blood Donors ◽  
Protein S ◽  
International Normalized Ratio ◽  
Activated Partial Thromboplastin Time ◽  
Dry Ice ◽  
Fresh Plasma ◽  
Immediate Analysis ◽  
And Storage

AbstractBackground:We recently observed that exposure to dry ice lowered sample pH and increased clotting times in lupus anticoagulant analyses, and that such changes could be prevented by placing samples at −80°C after dry ice exposure. In the current study, we sought to evaluate the effects of dry ice exposure on pH and various commonly used coagulation analyses.Methods:Citrated plasma from 30 healthy blood donors was allocated to four preanalytical regimes: (1) immediate analysis of fresh plasma or (2) storage at −20°C; (3) storage at −20°C followed by dry ice exposure for 24 h or (4) storage at −20°C followed by dry ice exposure for 24 h and storage at −80°C for 24 h before analysis. Analyses of pH, prothrombin time international normalized ratio (PT-INR), activated partial thromboplastin time (APTT), antithrombin, fibrinogen, protein C and protein S was performed.Results:Samples exposed to dry ice had significantly lower pH, prolonged clotting times in PT-INR, APTT and fibrinogen analyses as well as lower levels of protein C, than samples not exposed to dry ice. These changes in coagulation analyses were not present if samples were stored at −80°C for 24 h after dry ice exposure. Antithrombin and protein S were not significantly affected by dry ice exposure.Conclusions:Dry ice exposure lowered sample pH and affected various coagulation analyses. These effects were avoided by storing samples at −80°C for 24 h after dry ice exposure.

A Comparison of Glass and Plastic Blood Collection Tubes for Routine and Specialized Coagulation Assays: A Comprehensive Study

2006 ◽  
Vol 130 (1) ◽  
pp. 39-44 ◽  
Author(s):  
Alexander Kratz ◽  
Nancy Stanganelli ◽  
Elizabeth M. Van Cott
Keyword(s):  
Partial Thromboplastin Time ◽  
Protein C ◽  
Protein S ◽  
International Normalized Ratio ◽  
Activated Partial Thromboplastin Time ◽  
Blood Collection ◽  
Thrombin Time ◽  
Coagulation Assays ◽  
Glass Tubes ◽  
Blood Collection Tubes

Abstract Context.—Blood collection tubes made from plastic are beginning to replace glass tubes. Coagulation test results can be influenced easily by preanalytic factors, including exposure to surfaces that activate the clotting cascade. Objective.—To compare the effects of the blood collection tube material on 22 coagulation assays performed in clinical laboratories. Design.—Paired blood samples from 28 healthy volunteers were drawn into BD Vacutainer Glass Citrate Tubes and BD Vacutainer Plus Plastic Citrate Tubes, and the results of coagulation assays were determined in parallel. Results.—No statistically significant differences were observed between glass and plastic for 14 assays: prothrombin time (and international normalized ratio); activated partial thromboplastin time; activated protein C resistance; antithrombin activity; factors II, V, VIII, and IX; α2-antiplasmin; plasminogen activity; von Willebrand factor antigen; ristocetin cofactor; thrombin time; and reptilase time. Statistically significant differences were found for fibrinogen; chromogenic protein C activity; protein S activity; PTT-LA lupus anticoagulant–sensitive activated partial thromboplastin time; and factors VII, X, XI, and XII. Mean differences ranged from 0.4% to 5.5% and were unlikely to be of clinical significance. Conclusions.—The results of this study suggest that plastic tubes can be used in place of glass tubes for a wide variety of coagulation assays.

Plasma Levels of Protein S, Protein C, and Factor X: Effects of Sex, Hormonal State and Age

1995 ◽  
Vol 74 (05) ◽  
pp. 1271-1275 ◽  
Author(s):  
C M A Henkens ◽  
V J J Bom ◽  
W van der Schaaf ◽  
P M Pelsma ◽  
C Th Smit Sibinga ◽  
...  
Keyword(s):  
Regression Analysis ◽  
Postmenopausal Women ◽  
Protein C ◽  
Blood Donors ◽  
Premenopausal Women ◽  
Protein S ◽  
The Other ◽  
Factor X ◽  
Normal Ranges

SummaryWe measured total and free protein S (PS), protein C (PC) and factor X (FX) in 393 healthy blood donors to assess differences in relation to sex, hormonal state and age. All measured proteins were lower in women as compared to men, as were levels in premenopausal women as compared to postmenopausal women. Multiple regression analysis showed that both age and subgroup (men, pre- and postmenopausal women) were of significance for the levels of total and free PS and PC, the subgroup effect being caused by the differences between the premenopausal women and the other groups. This indicates a role of sex-hormones, most likely estrogens, in the regulation of levels of pro- and anticoagulant factors under physiologic conditions. These differences should be taken into account in daily clinical practice and may necessitate different normal ranges for men, pre- and postmenopausal women.

scholarly journals ASSESSMENT OF COAGULATION PROFILE IN PATIENTS WITH LIVER CIRRHOSIS AND ATRIAL FIBRILLATION

2021 ◽  
Vol 121 (1) ◽  
pp. 22-31
Author(s):  
Alіna Baylo ◽  
Vadym Shypulіn ◽  
Volodymyr Chernyavskyi ◽  
Luiza Parunyan
Keyword(s):  
Atrial Fibrillation ◽  
Liver Cirrhosis ◽  
Prothrombin Time ◽  
Partial Thromboplastin Time ◽  
International Normalized Ratio ◽  
Activated Partial Thromboplastin Time ◽  
Fibrinolytic System ◽  
Thrombin Time ◽  
Group I ◽  
D Dimer

The comorbid course of liver cirrhosis and atrial fibrillation causes higher levels of hospitalizations, mortality and ischemic stroke. According to current data, hemostasis in patients with liver cirrhosis is in a rebalanced dynamic state, but there are no data on the effect of atrial fibrillation on the hemostasis in patients with liver cirrhosis. Aims of the study. To assess abnormalities in primary, secondary haemostasis and fibrinolytic system in patients with liver cirrhosis and atrial fibrillation by using standard laboratory coagulation parameters and to investigate their changes depending on the stage of liver cirrhosis A, B, C according to Child-Pugh score. Materials and methods. A cross-sectional prospective study was conducted with the inclusion of 106 patients aged 42 to 83 years: group I (n = 70) - with liver cirrhosis and atrial fibrillation, II (n = 36) - with liver cirrhosis, which were distributed depending on the Child-Pugh score stages of cirrhosis and 20 healthy individuals. The levels of platelets, activated partial thromboplastin time, international normalized ratio, prothrombin time, thrombin time, fibrinogen, D-dimer were assessed on a Steellex M200 coagulometer. Statistical analysis (IBM SPSS Statistics) was performed. Results. The level of platelets in patients of group I was reduced by 37.4% (200 ± 8.33 vs. 274.7 ± 3.4; p,000.001), an activated partial thromboplastin time was prolonged by 38.6% (44.35 ± 1.39 vs. 32.01 ± 0.63, p˂0.001), prothrombin time was prolonged by 73.5% (19.4 ± 0.87 vs. 11.18 ± 0.53, p˂0.001), thrombin time was prolonged by 2.07 (25, 7 ± 1.31 vs. 12.4 ± 0.66, p˂0.001), the international normalized ratio was increased by 24.3% (1.38 ± 0.04 vs.1.11 ± 0.01, p˂0.001) compared to control. The fibrinogen level was 20.9% higher (4.17 ± 0.17 vs. 3.45 ± 0.11, p˂0.001) than in control group and was 83.7% higher (4.17 ± 0.17 vs. 2.27 ± 0.13, p˂0.001) than in group II. The D-dimer level was 83% higher than in control (675 ± 22.3 vs. 368.8 ± 21.85, p˂0.001) and 44% higher (675 ± 22.3 vs. 469 ± 37.18, p ˂0.001) compared with group II. Conclusions. In patients with liver cirrhosis and atrial fibrillation abnormalities of primary hemostasis are detected due to decrease of platelets on the background of portal hypertension. At the secondary stage of hemostasis indicators of external and internal coagulation mechanisms are prolonged due to the reduced synthesis of coagulation factors by the liver. Increased level of fibrinogen is determined at the stage of compensated and subcompensated cirrhosis with a gradual decrease at the stage of decompensation. The high activity of the fibrinolytic system is observed due to increase in the D-dimer levels, which may indicate a prothrombotic state in these patients.

Diabetes does not influence activation of coagulation, fibrinolysis or anticoagulant pathways in Gram-negative sepsis (melioidosis)

2011 ◽  
Vol 106 (12) ◽  
pp. 1139-1148 ◽  
Author(s):  
Joost Meijers ◽  
Rapeephan Maude ◽  
Direk Limmathurotsakul ◽  
Nicholas Day ◽  
Sharon Peacock ◽  
...  
Keyword(s):  
Protein C ◽  
Burkholderia Pseudomallei ◽  
Blood Donors ◽  
Protein S ◽  
Admission Diagnosis ◽  
Procoagulant Effect ◽  
Multiple Abnormalities ◽  
The Impact ◽  
D Dimer

SummaryDiabetes is associated with a disturbance of the haemostatic balance and is an important risk factor for sepsis, but the influence of diabetes on the pathogenesis of sepsis remains unclear. Melioidosis (Burkholderia pseudomallei infection) is a common cause of community-acquired sepsis in Southeast Asia and northern Australia. We sought to investigate the impact of pre-existing diabetes on the coagulation and fibrinolytic systems during sepsis caused by B. pseudomallei. We recruited a cohort of 44 patients (34 with diabetes and 10 without diabetes) with culture-proven melioidosis. Diabetes was defined as a pre-admission diagnosis of diabetes or an HbA1c>7.8% at enrolment. Thirty healthy blood donors and 52 otherwise healthy diabetes patients served as controls. Citrated plasma was collected from all subjects; additionally in melioidosis patients follow-up specimens were collected seven and ≥28 days after enrolment where possible. Relative to uninfected healthy controls, diabetes per se (i.e. in the absence of infection) was Characterised by a procoagulant effect. Melioidosis was associated with activation of coagulation (thrombin-antithrombin complexes (TAT), prothrombin fragment F1+2 and fibrinogen concentrations were elevated; PT and PTT prolonged), suppression of anti-coagulation (antithrombin, protein C, total and free protein S levels were depressed) and abnormalities of fibrinolysis (D-dimer and plasmin-antiplasmin complex [PAP] were elevated). Remarkably, none of these haemostatic alterations were influenced by pre-existing diabetes. In conclusion, although diabetes is associated with multiple abnormalities of coagulation, anticoagulation and fibrinolysis, these changes are not detectable when superimposed on the background of larger abnormalities attributable to B. pseudomallei sepsis.

Protein C, Protein S and c4b-Binding Protein in Severe lnfection and Septic Shock

1991 ◽  
Vol 65 (02) ◽  
pp. 126-129 ◽  
Author(s):  
J F Hesselvik ◽  
J Malm ◽  
B Dahlbäck ◽  
M Blombäck
Keyword(s):  
Septic Shock ◽  
Total Protein ◽  
Protein C ◽  
Blood Donors ◽  
Antithrombin Iii ◽  
Severe Infection ◽  
Protein S ◽  
C Protein ◽  
Normal Value ◽  
Free Protein

SummaryWe measured concentrations of the natural anticoagulant protein C; its cofactor, protein S; and the carrier protein C4bbinding protein (C4BP), in 24 patients with severe infection and 13 with septic shock. Decreased antithrombin III levels were found in 16 of 24 infection patients and all shock patients; high thrombin-antithrombin (TAT) complexes were present in 16 of 24 infection and 12 of 13 shock patients. Protein C concentrations were significantly reduced compared to healthy blood donors, to 60 ± 14% (infection) and 47 ± 20% (septic shock) (mean ± 1 SD). Total protein S levels were not reduced (119 ± 36.7 and 88 ± 20.0%, normal value 96±15%). Free protein S was also normal (27 ± 9.4 and 30 ± 8.7%, normal value 29 ± 9%). The percentage free of total protein S was normal in shock patients (35 ± 8.5%), but significantly reduced in patients without shock (23 ± 5.3%). C4BP was significantly higher than normal in the latter group (135 ± 43%), but not in the shock group (118 ± 40%), possibly due to increased consumption. Thus, no deficiency of total or free protein S was found in these patients, who had evidence of activated coagulation but no clinical DIC.

The Control Of Heparin Administration By The Activated Partial Thromboplastin Time(APTT)

1981 ◽  
Author(s):  
Jean M Thomson
Keyword(s):  
Quality Control ◽  
Partial Thromboplastin Time ◽  
Activated Partial Thromboplastin Time ◽  
Reference Laboratory ◽  
Plasma Samples ◽  
Heparin Administration ◽  
National Quality ◽  
Fresh Plasma ◽  
Low Levels ◽  
The Uk

The UK National Quality Control Trials have previously shown that the various APTT methods differ in their ability to detect low levels of heparin (Poller et al 1980). UK and US proficiency surveys have also shown lack of linearity of some APTT methods over a range of heparin concentrations. A further, recent collaborative exercise, using lyophilised plasma from a heparinised donor, has confirmed that most of the commonly-used commercial reagents have a higher threshhold of sensitivity to heparin than the reference reagent provided by the National (UK) Reference Laboratory. Additional studies on fresh plasma samples obtained from heparinised patients, have demonstrated considerable variations in the detection of heparin by widely-used commercial APTT techniques.

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