Rapid laboratory testing for trauma patients: where a perfect result may not be in the best interests of the patient

Callum, Jeannie; Rizoli, Sandro; Pendergrast, Jacob

doi:10.1111/j.1537-2995.2010.02934.x

Cited by 2 publications

(2 citation statements)

References 19 publications

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“…This at times leads to delay in treatment of patients with bleeding disorders especially in critical care settings like operation theatres, emergency rooms or trauma units. Clinical decision making can be faster if the TAT for coagulation results in these settings can be reduced [4][5][6].…”

Section: Introductionmentioning

confidence: 99%

Comparison of Rapid Centrifugation Technique with Conventional Centrifugation for Prothrombin Time (PT) and Activated Partial Thromboplastin Time (APTT) Testing

Chandler

Kakkar

Kaur

2018

Indian J Hematol Blood Transfus

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Prothrombin Time (PT) and activated partial thromboplastin time (APTT) are frequently performed coagulation tests in patients with coagulation disorders especially in critical care areas and in monitoring patients on anticoagulation therapy. In coagulation testing, sample processing especially centrifugation is one of the most critical steps that affect turnaround time (TAT). This study was carried out over a period of 1 year. Three hundred paired samples from patients sent for PT and APTT estimation were included. One sample was centrifuged in a regular bench top centrifuge at 1500g for 20 min. The other sample was divided into two polypropylene aliquots and centrifuged in a microcentrifuge at 13000g for 3 min. The plasma obtained from both methods was tested for PT and APTT using the automated method on STA Compact coagulometer (Stago) using commercial thromboplastin STA R-Neoplastine R C1 Plus and phospholipid (cephalin), STA R-C K PREST R 5 respectively. Data were analyzed using descriptive statistics, Student t test, correlation coefficient and Bland-Altman plots. Mean PT, INR and APTT for both centrifugation methods was comparable with no statistically significant difference (p [ 0.05). PT, INR and APTT also showed good correlation (r [ 0.98) when compared between the two methods of centrifugation. Bland-Altman comparison between rapid and conventional methods of centrifugation for PT, INR and APTT also showed acceptable agreement. Rapid centrifugation technique for routine coagulation testing can be used safely with a significant reduction in the TAT. This can benefit patients in critical care settings and those on outpatient oral anticoagulant therapy.

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Section: Introductionmentioning

confidence: 99%

Comparison of Rapid Centrifugation Technique with Conventional Centrifugation for Prothrombin Time (PT) and Activated Partial Thromboplastin Time (APTT) Testing

Chandler

Kakkar

Kaur

2018

Indian J Hematol Blood Transfus

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“…In more than 60 countries worldwide, laboratory testing plays a challenging and expensive role in trauma resuscitation. [ 1 , 2 ] Initial assessment protocols suggest routine laboratory testing to obtain enough information about the hemodynamic and respiratory condition of the patient, including the severity of occult blood loss and metabolic stability. These concern comprehensive blood sample analyses, including hematologic, arterial blood gas, coagulation, kidney, and liver panels.…”

Section: Introductionmentioning

confidence: 99%

The use of routine laboratory testing in acute trauma care: a retrospective analysis

Popal¹

2021

Ulus Travma Acil Cerrahi Derg

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BACKGROUND: In more than 60 countries worldwide, laboratory testing plays a challenging and expensive role in trauma resuscitation. In 1995, the literature already suggested that routine laboratory testing may not be useful for most trauma patients. Our study hypothesized that still the need for some laboratory tests perhaps should be reconsidered. Therefore, the aim of this study was to create more insight in the distribution between normal and abnormal parameters for routine laboratory testing in trauma patient management. METHODS: This retrospective analysis was performed at Amsterdam UMC, location AMC, an academic level 1 trauma center. Data concerning age, gender, American Society of Anesthesiologists (ASA) physical state classification system (ASA), Injury Severity Scores, Glasgow Coma Scales, mechanism of injury, presence of high-energy trauma, and type of injury (blunt or penetrating) were obtained. Laboratory parameters included comprehensive hematology, coagulation, arterial blood gas, kidney, and liver blood panels. Analytical focus was paid to the patient’s vital status, the indication for an emergency intervention, and the risk of in-hospital mortality. RESULTS: A total of 1287 patients were included in the study. Patients with unstable vital signs or who required emergency intervention were most often dealing with abnormalities in pO 2 , glucose, D-dimer, creatinine, and alcohol values. Mean corpuscular volume (MCV), international normalized ratio (INR), fibrinogen, and amylase were obtained in more than 80% of the patients, but in specific patient groups only abnormal in less than 9%. CONCLUSION: Trauma patients suffer mainly from abnormal values of D-dimer, pO 2 , glucose, creatinine, and alcohol. By contrast, MCV, INR, amylase, fibrinogen, and thrombocytes are regularly obtained as well, but only abnormal in a small amount of trauma patients. These findings suggest reconsiderations and more accuracy in the performance of laboratory testing, especially for trauma patients with stable vital signs.

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Rapid laboratory testing for trauma patients: where a perfect result may not be in the best interests of the patient

Cited by 2 publications

References 19 publications

Comparison of Rapid Centrifugation Technique with Conventional Centrifugation for Prothrombin Time (PT) and Activated Partial Thromboplastin Time (APTT) Testing

Comparison of Rapid Centrifugation Technique with Conventional Centrifugation for Prothrombin Time (PT) and Activated Partial Thromboplastin Time (APTT) Testing

The use of routine laboratory testing in acute trauma care: a retrospective analysis

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