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Studies of Bacterial Chemotaxis Using Microfluidics - Interview
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Microfluidics contrasted to thrombelastography: perplexities in defining hypercoagulability.

Peter J Lawson1, Hunter B Moore1, Ernest E Moore2

  • 1Department of Surgery, University of Colorado School of Medicine, Aurora, Colorado.

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|October 4, 2018
PubMed
Summary

Elevated clot strength measured by thrombelastography (TEG) correlates with thrombotic risks, but its relationship with flow conditions and fibrinolysis remains unclear. This study found limited correlation between TEG and microfluidic T-TAS measurements, except under t-PA challenge, revealing complex interactions.

Keywords:
HypercoagulableMicrofluidicsPlateletT-TASTEGThrombelastography

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Area of Science:

  • Biomedical Engineering
  • Hematology
  • Thrombosis Research

Background:

  • Elevated clot strength (maximum amplitude [MA]) by thrombelastography (TEG) is linked to thrombotic complications.
  • The translation of MA to thrombotic risk under flow conditions and its interaction with clot degradation is not well understood.
  • This study investigates the correlation between clot strength and time-dependent coagulation/fibrinolysis under flow.

Purpose of the Study:

  • To evaluate the correlation between TEG measurements and microfluidic T-TAS under flow conditions.
  • To assess how clot strength (MA) and hypercoagulability relate to time-dependent coagulation and fibrinolysis resistance.
  • To explore the clinical utility of T-TAS in conjunction with TEG for predicting thrombotic risks.

Main Methods:

  • Surgical patients at high risk for thrombotic complications were analyzed using TEG and T-TAS.
  • TEG hypercoagulability was defined by specific r, angle, MA, and LY30 values.
  • T-TAS assessed clotting under arterial shear rates using AR and PL chips, measuring occlusion start time, occlusion time (OT), occlusion speed (OSp), and total clot generation.
  • Both assays were challenged with tissue plasminogen activator (t-PA) to evaluate fibrinolysis resistance.

Main Results:

  • No significant correlation was found between most TEG indices and T-TAS AR/PL chip measurements in the patient cohort.
  • Under t-PA challenge, T-TAS AR's OSp showed inverse relationships with TEG angle and LY30, and a positive correlation with R time.
  • TEG-defined hypercoagulability by MA correlated with shorter T-TAS PL occlusion times, while hypercoagulability by LY30 showed discordant results with prolonged OT and slower OSp.

Conclusions:

  • Microfluidic T-TAS generally shows poor correlation with TEG measurements in hypercoagulable patients, except when challenged with t-PA.
  • Elevated MA correlated with faster platelet-mediated occlusion, supporting its role in hypercoagulability.
  • Discordant findings for LY30 highlight the need for further research into clot strength, fibrinolysis, and flow dynamics.