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Leveraging Turbidity and Thromboelastography for Complementary Clot Characterization
Published on: June 4, 2020
Can Thromboelastography performed on kaolin-activated citrated samples from critically ill patients provide stable
H White1, C Zollinger, M Jones
1Department of Critical Care, Logan Hospital, Griffith University, Brisbane, Australia. hayden_white@health.qld.gov.au
International Journal of Laboratory Hematology
|March 24, 2009
Summary
Citrate blood tubes allow for delayed processing of thromboelastography (TEG) specimens. However, delaying kaolin-activated TEG analysis beyond 30 minutes significantly alters results, impacting accuracy in critically ill patients.
Area of Science:
- Hematology
- Clinical Pathology
- Critical Care Medicine
Background:
- Thromboelastography (TEG) offers valuable insights into hemostasis but has time-sensitive analysis requirements.
- Citrate anticoagulation in blood collection tubes may extend specimen processing windows.
- Limited data exists on the stability and processing time effects on citrate TEG results.
Purpose of the Study:
- To investigate the impact of early versus delayed processing on TEG parameters.
- To assess the accuracy of kaolin-activated TEG using citrated blood samples from intensive care unit (ICU) patients.
Main Methods:
- TEG analysis was performed on 61 critically ill patients' blood samples collected in 3.2% sodium citrate tubes.
- Kaolin-activated samples were analyzed at 15, 30, and 120 minutes postcollection.
- Key TEG parameters including R time, K time, and alpha angle were evaluated.
Main Results:
- Significant associations were found between time from collection and TEG results (P < 0.05).
- Differences were primarily observed between 30 and 120 minutes postcollection.
- Progressive changes, like decreasing R time, suggested a trend toward hypercoagulability.
Conclusions:
- Kaolin-activated citrate TEG specimens can be processed starting at 15 minutes postvenipuncture.
- Processing delays exceeding 30 minutes lead to significant alterations in TEG parameter accuracy.
- Optimizing processing time is crucial for reliable TEG interpretation in critically ill populations.
