Hostname: page-component-586b7cd67f-l7hp2 Total loading time: 0 Render date: 2024-11-28T00:43:53.488Z Has data issue: false hasContentIssue false

Just scratching the surface: varied coagulation effects of polymer containers on TEG variables

Published online by Cambridge University Press:  23 December 2005

A. M. Roche
Affiliation:
Duke University Medical Center, Department of Anesthesiology, Durham, NC, USA
M. F. M. James
Affiliation:
University of Cape Town, Department of Anaesthesia, Cape Town, South Africa
M. P. W. Grocott
Affiliation:
University College London, Department of Anaesthesia, London, UK
M. G. Mythen
Affiliation:
University College London, Department of Anaesthesia, London, UK
Get access

Extract

Summary

Background and objective: Different types of polymer surfaces affect the activation of platelets and coagulation pathway containers depending on their surface qualities. Importantly, this could produce variability of coagulation results obtained with thrombelastographical analysis. We assessed the effects of blood storage on thrombelastograph, TEG®, variables using polypropylene and polycarbonate containers. Methods: An in vitro experiment was performed, with eight volunteers in each limb. Fresh whole blood was stored in polypropylene or polycarbonate tubes prior to TEG® analysis, to assess the role of these plastics in the TEG® results obtained. Results: The polycarbonate tubes displayed slower onset of coagulation and greater variability of data for all four basic TEG variables (r-time, k-time, α-angle and maximum amplitude, P < 0.05). Polycarbonate results fell outside manufacturer reference ranges. Conclusions: It is likely that this is due to the altered surface properties and charge effects of the containers affecting proteins and platelets differently. Caution should be used in choosing which containers are used for storage of fresh blood prior to coagulation assessment, as variable results will follow where different types of plastic containers are employed.

Type
Original Article
Copyright
© 2006 European Society of Anaesthesiology

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

Mallett SV, Cox DJ. Thrombelastography [see comments]. Br J Anaesth 1992; 69: 307313.Google Scholar
Polack B, Barro C, Pernod G et al. Impact of the blood collection tube on the activation of coagulation. Thromb Haemost 1997; 77: 217218.Google Scholar
Hench LL, Ethridge EC. Biomaterials. An Interfacial Approach. New York: Academic Press, 1982.
Blackburn EK, Shinton NK. Blood specimen collection tubes for coagulation tests. J Clin Pathol 1979; 32: 741.Google Scholar
Musgrave KA, Triplett DA. Hematology, Clinical and Laboratory Practice. St Louis: Mosby Year Book, Inc., 1993.
Palmer RN, Gralnick HR. Inhibition of cold-promoted activation of the prothrombin time studies of new siliconized borosilicate collection tubes in normals and patients receiving warfarin. Am J Clin Pathol 1985; 83: 492494.Google Scholar
Lemm W, Frauboes C, Bucherl ES. Blood–material interaction, ex-vivo test for the initial events. Life Support Syst 1985; 3 (Suppl 1): 481485.Google Scholar
Roche AM, James MF, Grocott MP, Mythen MG. Coagulation effects of in vitro serial haemodilution with a balanced electrolyte hetastarch solution compared with a saline-based hetastarch solution and lactated Ringer's solution. Anaesthesia 2002; 57: 950955.Google Scholar
Exner T, Koutts J, Hughes W, Gibson G. Inappropriate use of non-siliconized citrate tubes for clotting tests. Pathology 1990; 22: 50.Google Scholar
Park JB, Lakes RS. Biomaterials. An Introduction. New York: Plenum Press, 1992.
Nygren H, Braide M, Karlsson C. Different kinetics of the respiratory burst response in granulocytes, induced by serum from blood coagulated in contact with polymer materials. Biomaterials 2000; 21: 173182.Google Scholar
Martin MJ, Gordon YB, Ratky SM et al. Conditions for collection of serum samples for the measurement of fibrin(ogen) degradation products by radioimmunoassay of fragment E. J Clin Pathol 1976; 29: 336340.Google Scholar
Laessig RH, Hassemer DJ, Hoffman GL et al. A comparison of hard and soft glass blood-drawing tubes. Am J Clin Pathol 1979; 72: 952955.Google Scholar
Shaw DJ. Electrophoresis. London: Academic Press, 1969.
Coleman DL, Gregonis DE, Andrade JD. Blood–materials interactions: the minimum interfacial free energy and the optimum polar/apolar ratio hypotheses. J Biomed Mater Res 1982; 16: 381398.Google Scholar
Forbes CD, Prentice CR. Thrombus formation and artificial surfaces. Br Med Bull 1978; 34: 201207.Google Scholar
Nygren H, Elam JH, Stenberg M. Adsorption of coagulation proteins and adhesion and activation of platelets at the blood–solid interface. An experimental study of human whole blood. Acta Physiol Scand 1988; 133: 573577.Google Scholar
Okano T, Aoyagi T, Kataoka K et al. Hydrophilic– hydrophobic microdomain surfaces having an ability to suppress platelet aggregation and their in vitro antithrombogenicity. J Biomed Mater Res 1986; 20: 919927.Google Scholar