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Effects of a hemoglobin-based oxygen carrier (HBOC-201) on coagulation testing
J S Jahr1, F Lurie, R Gosselin
1Department of Anesthesiology, University of California Davis Medical Center, 4150 V Street, Suite 1200, Sacramento, CA 95817, USA.
Summary
Polymerized bovine hemoglobin (HBOC-201) can interfere with coagulation tests. Mechanical detection methods showed less interference than optical methods when analyzing HBOC-201 effects on plasma.
Area of Science:
- Clinical Chemistry
- Hematology
- Biomedical Engineering
Background:
- Polymerized bovine hemoglobin (HBOC-201) is explored as a blood substitute.
- HBOC-201's hemolyzed appearance may impact laboratory testing.
- Coagulation tests are crucial for assessing hemostasis.
Purpose of the Study:
- To evaluate the interference of HBOC-201 on common coagulation assays.
- To compare the impact of HBOC-201 on different detection methods used in coagulation analyzers.
Main Methods:
- Pooled normal plasma was spiked with HBOC-201 to achieve various hemoglobin concentrations (1.4–6.2 g/dL).
- Coagulation parameters including prothrombin time (PT), activated partial thromboplastin time, fibrinogen, and antithrombin were measured.
- Results from HBOC-201 samples were compared to saline-matched controls, with >10% difference indicating interference.
Main Results:
- Increasing HBOC-201 concentrations affected coagulation test accuracy.
- Mechanical detection methods (fibrometer, STA, CS-190, MDA-180) demonstrated less interference compared to optical detection devices.
- Interference varied across different coagulation parameters and detection principles.
Conclusions:
- HBOC-201 can interfere with standard coagulation testing.
- Mechanical detection systems appear more robust against HBOC-201 interference than optical systems.
- Careful consideration of analyzer type is needed when monitoring coagulation in patients receiving HBOC-201.
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