Whole blood impedance aggregometry detects heparin-induced thrombocytopenia antibodies

Morel-Kopp, Marie-Christine; Aboud, Margaret; Tan, Chee Wee; Kulathilake, Chandima; Ward, Christopher

doi:10.1016/j.thromres.2009.12.001

Cited by 39 publications

(38 citation statements)

References 24 publications

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“…[1][2][3][4][5][9][10][11][12][13] Other tests of platelet function are less applicable for VLBW neonates, principally because of a larger volume of blood needed. These include light transmittance platelet aggregometry, 14 whole-blood aggregometry, 15 multiple electrode aggregometry, 16 thromboelastography 17 and vasodilator-stimulated phosphoprotein phosphorylation. 18 Ampicillin impairs platelet function and prolongs the bleeding time, 5-8 but it does not do so immediately as occurs with clopidogrel (plavix) or aspirin.…”

Section: Discussionmentioning

confidence: 99%

Effect of ampicillin on bleeding time in very low birth-weight neonates during the first week after birth

et al. 2011

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Objective: On the day of birth, the bleeding time of very low birth-weight (VLBW, <1500 g) neonates is generally prolonged, compared with term neonates. However, their bleeding time generally improves (shortens) over the next 7 to 10 days. Ampicillin can prolong the bleeding times of term and late preterm neonates, but its effect on VLBW neonates, who already have a somewhat prolonged bleeding time initially, is not known.Syudy Design: This was a prospective, single-centered, paired, before vs after test of the effect of ampicillin on template bleeding time and PFA-100 time (platelet function analyzer). Ampicillin was dosed at every 12 h intravenously, but decisions about discontinuation were made by the responsible clinician, independent of this study.Result: A total of 20 VLBW neonates were studied. They ranged from 23-to 30-weeks gestation at birth and weighed 500 to1410 g. Initial bleeding times averaged 166 s (95% CI, 138 to 194) and initial PFA-100 times averaged 119 s (95% CI, 90 to 148). In all, 10 had ampicillin dosing stopped after a shorter course (4 to 7 doses) and 10 had it continued for a longer course (10 to 15 doses). Blood cultures were sterile in all 20, and no differences in laboratory or clinical features were found between those treated with a shorter vs longer course. After stopping the ampicillin following a short course the bleeding times and PFA-100 times were similar to the initial values. However, after a longer course the bleeding times were prolonged by an average of 2 min, to 284 s (95% CI, 242 to 326; P ¼ 0.001 vs initial). The PFA-100 times also trended longer by an average of 44 s (P ¼ 0.07). The number of doses of ampicillin received in the first week correlated with the degree of prolongation in bleeding time (r ¼ 0.68). Conclusion:Over the first week of life, a period when the bleeding time of VLBW neonates normally shortens, the opposite occurred (the bleeding time lengthened) if X10 doses of ampicillin were administered.

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Section: Discussionmentioning

confidence: 99%

Effect of ampicillin on bleeding time in very low birth-weight neonates during the first week after birth

et al. 2011

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“…Multiple electrode impedance aggregometry turned out to be a useful tool for hematology laboratories in detecting heparin-induced thrombocytopenia (HIT) [33,34,35]. HIT, a severe complication during treatment with heparin, is connected with the synthesis of IgG antibodies that activate platelets.…”

Section: Detection Of Heparin-induced Thrombocytopeniamentioning

confidence: 99%

Multiple electrode aggregometry – only for cardiologists?

Spałek

Żorniak

Krzemiński

2016

Ann. Acad. Med. Siles.

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Multiple electrode aggregometry is one of the newest technologies in platelet function monitoring. The idea of this assay is based on whole blood impedance aggregometry measurements. The main advantages of this device are rapid and easy use, no necessity of sample pre-processing or requiring a specialized laboratory. These features allow one to include this methodology in point-of-care testing methods that can be performed at the patient bedside. Five different pathways of platelet activation can be investigated by adding specific reaction agonists. Antiplatelet drugs, such as acetylsalicylic acid or clopidogrel, inhibit arachidonic acid-dependent and adenosine diphosphate-dependent pathways of platelet activation. Individual patient response to these drugs can be estimated using multiple electrode aggregometry. The identification of low-responders may result in reducing thrombosis events in this group and make antiplatelet treatment more effective. Furthermore, it is supposed to be a reliable method of estimating the risk of perioperative bleeding in adults undergoing cardiac surgery. Other potential clinical applications for this technology are being found. Many studies report its use in determining prognosis in severe sepsis, detecting heparin-induced thrombocytopenia and diagnosing von Willebrand disease. Although multiple electrode aggregometry seems to have great diagnostic potential, more tests need to be performed before it becomes standard hospital equipment. K E Y W O R DSmultiple electrode aggregometry, platelet function monitoring, antiplatelet therapy, platelet tests ST R ES ZCZ E NI EMetoda agregacji impedancyjnej jest jedną z najnowszych technik stosowanych w ocenie funkcji płytek krwi, wykorzystującą krew pełną jako środowisko reakcji. Zasada jej działania opiera się na pomiarach zmian impedancji, jakie następują na skutek agregacji płytek krwi po dodaniu egzogennego aktywatora. Najważniejszymi zaletami tej metody są: łatwość jej wykonania bez specjalistycznego laboratorium, brak konieczności wcześniejszego przetwarzania pobranej do badania próbki oraz szybkość w uzyskaniu wyników. Wszystkie te cechy pozwalają na wykonanie tego badania przy łóżku pacjenta. Metoda agregacji impedancyjnej pozwala na ocenę pięciu różnych szlaków aktywacji

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“…Paniccia et al [72] Paniccia et al [73] Sibbing et al [74] Sibbing et al [75] Würtz et al [77] Bolliger et al [78] Morel-Kopp et al [79] Ranucci et al [81] Görlinger et al [84] PFA-100 Innovance PFA-200…”

Section: Platelet Aggregation On Platelet-rich Plasmamentioning

confidence: 99%

“…Because MEA may use different agonists (similarly to LTA), it is suitable for diagnosis of bleeding and also for monitoring antiplatelet therapy [72][73][74][75][76][77] . Indeed, MEA has been used to investigate the presence of VWD in patient with severe aortic stenosis [78] and on the other hand the high thrombotic risk due to heparin induced thrombocytopenia (HIT) [79] . In particular, MEA, beyond the identification of cardiovascular patients at risk of MACE [72][73][74][75] , is able to discriminate those patients that have a too much high inhibition of platelet function and at risk of bleeding [80] .…”

Section: Platelet Aggregation On Wbmentioning

confidence: 99%

Assessment of platelet function: Laboratory and point-of-care methods

Paniccia¹

2014

WJTM

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In the event of blood vessel damage, human platelets are promptly recruited on the site of injury and, after their adhesion, activation and aggregation, prevent blood loss with the formation of a clot. The consequence of abnormal regulation can be either hemorrhage or the development of thrombosis. Qualitative and/or quantitative defects in platelets promote bleeding, whereas the residual reactivity of platelets, despite antiplatelet therapies, play an important role in promoting arterial thrombotic complications. Platelet function is traditionally assessed to investigate the origin of a bleeding syndrome, to predict the risk of bleeding prior surgery or during pregnancy or to monitor the efficacy of antiplatelet therapy in thrombotic syndromes that, now, can be considered a new discipline. "Old" platelet function laboratory tests such as the evaluation of bleeding time and the platelet aggregation analysis in platelet-rich plasma are traditionally utilized to aid in the diagnosis and management of patients with platelet and hemostatic disorders and used as diagnostic tools both in bleeding and thrombotic diathesis in specialized laboratories. Now, new and renewed automated systems have been introduced to provide a simple, rapid assessment of platelet function including point of care methods. These new methodologies are also suitable for being used in non-specialized laboratories and in critical area for assessing platelet function in whole blood without the requirement of sample processing. Some of these methods are also beginning to be incorporated into routine clinical use and can be utilized as not only as first panel for the diagnosis of platelet dysfunction, but also for monitoring anti-platelet therapy and to potentially assess risk of both bleeding and/or thrombosis.© 2014 Baishideng Publishing Group Inc. All rights reserved.Key words: Platelets; Method; Test; Point of care testing; Laboratory assessment; Bleeding; Thrombosis; Platelet function Core tip: This review discussed the scenario of available platelet function laboratory and point-of-care methods suitable in different clinical setting. As this matter has become of crucial importance in the bleeding management and for monitoring antiplatelet therapies, improved ability to assess platelet function in a timely and efficient manner is essential. Traditional platelet function methods, requiring a fair degree of expertise, have been limited to specialized laboratory. Many efforts have been carried out for improving platelet function assays for centralized laboratory, such as different point-of-care testing methodologies have been developed. Moreover, different guidelines and recommendations for their method standardization are growing.

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Whole blood impedance aggregometry detects heparin-induced thrombocytopenia antibodies

Cited by 39 publications

References 24 publications

Effect of ampicillin on bleeding time in very low birth-weight neonates during the first week after birth

Effect of ampicillin on bleeding time in very low birth-weight neonates during the first week after birth

Multiple electrode aggregometry – only for cardiologists?

Assessment of platelet function: Laboratory and point-of-care methods

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