Different effects of abciximab and cytochalasin D on clot strength in thrombelastography

Lang, Thomas; Toller, Wolfgang; Gütl, M; Mahla, Elisabeth; Metzler, H.; Rehak, Peter; März, W.; Halwachs‐Baumann, Gabriele

doi:10.1111/j.1538-7836.2004.00555.x

Cited by 119 publications

(92 citation statements)

References 45 publications

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“…Thromboplastin (tissue factor) from rabbit brain is used for activation of the extrinsic pathway in ExTEM, FibTEM and ApTEM (for explanation of abbreviations see footnote of table 1). FibTEM contains additional cytochalasin D in order to inhibit platelet activation [111,112]. ApTEM includes aprotinin in order to block hyperfibrinolysis.…”

Section: Rotational Thrombelastometry (Rotem)mentioning

confidence: 99%

Perioperative Coagulation Management and Control of Platelet Transfusion by Point-of-Care Platelet Function Analysis

Görlinger

Jámbor²,

Hanke

et al. 2007

Transfus Med Hemother

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About one third of all blood components transfused intraoperatively is used in cardiac surgery, whereas mortality of cardiosurgical patients correlates nearly linear with the number of transfused units of packed red blood cells. Acquired platelet function disorders play a major role in perioperative bleeding in cardiac surgery. Therefore, the use of point-of-care-suitable platelet function analyzers seems to be reasonable in this field. Methods: Platelet function analyzer PFA-100®, rotational thrombelastometry (ROTEM®), and multiple platelet function analyzer (Multiplate®) are in principle applicable for point-of-care testing. Since these three analyzers monitor different aspects of platelet function and have different limitations, the selection of the right test system depends on the right question. Results: Perioperative use of platelet function analyzers is helpful in prediction of blood loss in cardiac surgery. Perioperative usage of blood components and their respective costs can be reduced by an appropriate coagulation management. Conclusion: Algorithms for perioperative coagulation management based on point-of-care testing permit a fast diagnostic and goal-directed therapy of coagulation and functional platelet disorders. The possibility to reduce the mortality of patients and the overall cost for hospital stay is subject of further studies.

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Section: Rotational Thrombelastometry (Rotem)mentioning

confidence: 99%

Perioperative Coagulation Management and Control of Platelet Transfusion by Point-of-Care Platelet Function Analysis

Görlinger

Jámbor²,

Hanke

et al. 2007

Transfus Med Hemother

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“…The reference range for FibTEG is given with MCF 9-25 mm [4]. Originally, abciximab (ReoPro 10 mg / 5 ml) was used to target the inhibition of the GP IIb/IIIa receptors in the case of FibTEG, which was then changed by the manufacturer so that the reagent now contains cytochalasin D to eliminate platelet influence through inhibition of the actin/myosin system [27,28]. The excessive platelet count in this patient could possibly indicate that the quantity of cytochalasin was not sufficient to inhibit all platelets leading to an artefact in the measurement of the maximum FibTEG/ maximum amplitude.…”

Section: Results Of Platelet Function Measurementsmentioning

confidence: 99%

Thrombelastography Today: Practicability and Analytical Power

Hänecke¹,

Klouche²

2007

Transfus Med Hemother

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Today, rotational thrombelastography as a further development of the classical thrombelastography is increasingly applied to assess haemostasis and to predict complications of coagulation. Due to the improved robustness of the method, RoTEM analyses are now also performed outside specialised coagulation laboratories and applied in emergency settings. Since coagulation testing, particularly when performed with different activators, is very sensitive to artifacts due to variations in the proportion to anticoagulants, temperature and concentration of activators, meticulous quality control is indispensable. For this reason, the German Federal Chamber of Physicians has issued rigorous validity ranges for the classic coagulation tests, such as the prothrombin time (PT/INR) or the activated partial thromboplastin time (aPTT) for variation coefficient acceptance, which are audited 4 times a year by external quality control circles. At present, no comparable quality assurance setup exists for whole blood coagulation testing. Thus, knowledge of the analytical limits, restrictions and caveats of this method is central for critical interpretation of the results and reliable clinical application. This review gives an outline of the practicability and accuracy of the RoTEM methodology and illustrates some pitfalls for the use in detecting and predicting disturbances of haemostasis in a case report.

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“…Researchers pursuing a similar study 14 using in vitro addition of abciximab to human whole blood at similar concentrations did report a significant effect on automated ROTEG activated with Integ j (a proprietary contact activator for the intrinsic system containing ellagic acid and phospholipids), and specifically described a decrease in Ang and MA. An additional decrease in MA was seen with the addition of cytochalasin D to these mixtures.…”

Section: 21mentioning

confidence: 99%

“…This approach has been investigated in human patients following major abdominal and cardiac surgery, 12,17 as well as in healthy rabbits. 14 Many diseases in dogs have been associated with hypercoagulability and formation of venous or arterial thrombi, 11 and although antiplatelet medications (such as aspirin or clopidogrel) or anticoagulant medications (e.g., heparin) are frequently recommended, there are no data to delineate whether factorrelated hypercoagulability, platelet hyperactivity, or both contribute to the development of thrombi in a given patient. Knowledge of the primary component of hypercoagulability may allow more tailored thromboprophylactic treatments.…”

Section: Introductionmentioning

confidence: 99%

“…In-vitro studies that have used TEG or the related technology rotational thromboelastometry (ROTEG) to evaluate the effects of cytochalasin D on whole blood coagulation have been performed in human beings, rabbits, and pigs, and have confirmed these expectations. 14,22,30 Abciximab is a monoclonal Fab-fragment directed against the human platelet GPIIb/IIIa receptor. 29 The presence of abciximab prevents fibrinogen binding by the human GPIIb/ IIIa receptor.…”

Section: Introductionmentioning

confidence: 99%

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The effects of cytochalasin D and abciximab on hemostasis in canine whole blood assessed by thromboelastography and the PFA-100® platelet function analyzer system

2011

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Abstract. The selective inhibition of platelet function in whole blood coagulation testing may allow insights into the nature of hypercoagulability in dogs with critical illness. To determine the effects of cytochalasin D and abciximab on hemostatic parameters in canine citrated whole blood, an in-vitro study was designed using thromboelastography (TEG) and a platelet function analyzer (PFA-100®). 8 clinically healthy mixed breed dogs donated blood that was anticoagulated with 3.2% sodium citrate in a 9:1 blood-to-citrate ratio. Addition of cytochalasin D to citrated whole blood from 6 dogs at concentrations ranging from 0 µg/ml to 10 µg/ml caused a maximal reduction of TEG maximum amplitude (MA) at a concentration of 7.5 µg/ml (52.7 ± 4.3 to 14.3 ± 7.8 mm). Addition of abciximab to canine citrated whole blood at concentrations of either 20 µg/ml or 40 µg/ ml did not affect the TEG tracing; however, addition of abciximab to citrated canine whole blood at concentrations of 10 µg/ ml and 20 µg/ml significantly prolonged PFA-100 closure times (72.5 ± 15 to 149.2 ± 91 sec and 275.6 ± 54 sec, respectively, P < 0.04). Inhibition of canine platelet function by cytochalasin D is demonstrated by TEG, but abciximab did not change TEG tracings. Abciximab does, however, inhibit platelet aggregation under shear stress as measured by the PFA-100. Inhibition of canine platelet function with cytochalasin D may allow further TEG studies in dogs with clinical disease.

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Different effects of abciximab and cytochalasin D on clot strength in thrombelastography

Cited by 119 publications

References 45 publications

Perioperative Coagulation Management and Control of Platelet Transfusion by Point-of-Care Platelet Function Analysis

Perioperative Coagulation Management and Control of Platelet Transfusion by Point-of-Care Platelet Function Analysis

Thrombelastography Today: Practicability and Analytical Power

The effects of cytochalasin D and abciximab on hemostasis in canine whole blood assessed by thromboelastography and the PFA-100® platelet function analyzer system

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