Fibrinogen estimates are influenced by methods of measurement and hemodilution with colloid plasma expanders
Fibrinogen estimates are influenced by methods of measurement and hemodilution with colloid plasma expanders
BACKGROUND: Measurement of plasma fibrinogen is often required in critically ill patients or massively bleeding patients being resuscitated with colloid plasma expander. This study aimed at evaluating different assays of plasma fibrinogen after in vitro dilution with commonly used plasma expanders and challenged the hypothesis that levels of fibrinogen are estimated significantly higher in plasma diluted with colloid plasma expander compared with isotonic saline.
STUDY DESIGN AND METHODS: Fibrinogen measurements were established in plasma samples each diluted in vitro to 30 or 50% with isotonic saline, hydroxyethyl starch (HES) 130/0.4, and human albumin. Fibrinogen levels were assessed using an antigen determination, three photo-optical Clauss methods, one mechanical Clauss method, a prothrombin-derived method, and viscoelastic measurement through thromboelastometry.
RESULTS: Measurement of fibrinogen levels was significantly different when performed on alternate analytical platforms. By 30 and 50% dilution with HES 130/0.4 coagulation analyzers using the photo-optical Clauss methods significantly overestimated levels of fibrinogen. Dilution with human albumin did not affect fibrinogen levels except from one analyzer by 50% dilution level. Viscoelastic measurement of fibrin polymerization was reduced at both dilution levels and appeared to reflect the impairment of fibrin polymerization induced by HES 130/0.4 and to a lesser extent human albumin.
CONCLUSION: This study demonstrated that different automated coagulation analyzers revealed significantly different levels of fibrinogen. The presence of colloid plasma expander gave rise to erroneous high levels of fibrinogen returned from some coagulation analyzers employing the method of Clauss.
Blood Coagulation/drug effects, Blood Preservation/methods, Blood Specimen Collection/methods, Colloids, Cryoprotective Agents/pharmacology, Fibrinogen/analysis, Hematologic Tests/instrumentation, Hemodilution/methods, Humans, Sodium Chloride/pharmacology, Statistics as Topic/methods
2571-2576
Fenger-Eriksen, Christian
d31e67ee-9d8a-4873-8cf2-cc59c5f88d4f
Moore, Gary W
4a0d6b47-e6ba-458a-bc31-33431fef5a5a
Rangarajan, Savita
9a5e4c7e-55ba-4a3a-b5f6-f1e269d927c3
Ingerslev, Jørgen
c1715e76-9ecb-436b-9d06-c06c231b3860
Sørensen, Benny
7870097f-91ed-4926-94c9-05ed60fcea96
December 2010
Fenger-Eriksen, Christian
d31e67ee-9d8a-4873-8cf2-cc59c5f88d4f
Moore, Gary W
4a0d6b47-e6ba-458a-bc31-33431fef5a5a
Rangarajan, Savita
9a5e4c7e-55ba-4a3a-b5f6-f1e269d927c3
Ingerslev, Jørgen
c1715e76-9ecb-436b-9d06-c06c231b3860
Sørensen, Benny
7870097f-91ed-4926-94c9-05ed60fcea96
Fenger-Eriksen, Christian, Moore, Gary W, Rangarajan, Savita, Ingerslev, Jørgen and Sørensen, Benny
(2010)
Fibrinogen estimates are influenced by methods of measurement and hemodilution with colloid plasma expanders.
Transfusion, 50 (12), .
(doi:10.1111/j.1537-2995.2010.02752.x).
Abstract
BACKGROUND: Measurement of plasma fibrinogen is often required in critically ill patients or massively bleeding patients being resuscitated with colloid plasma expander. This study aimed at evaluating different assays of plasma fibrinogen after in vitro dilution with commonly used plasma expanders and challenged the hypothesis that levels of fibrinogen are estimated significantly higher in plasma diluted with colloid plasma expander compared with isotonic saline.
STUDY DESIGN AND METHODS: Fibrinogen measurements were established in plasma samples each diluted in vitro to 30 or 50% with isotonic saline, hydroxyethyl starch (HES) 130/0.4, and human albumin. Fibrinogen levels were assessed using an antigen determination, three photo-optical Clauss methods, one mechanical Clauss method, a prothrombin-derived method, and viscoelastic measurement through thromboelastometry.
RESULTS: Measurement of fibrinogen levels was significantly different when performed on alternate analytical platforms. By 30 and 50% dilution with HES 130/0.4 coagulation analyzers using the photo-optical Clauss methods significantly overestimated levels of fibrinogen. Dilution with human albumin did not affect fibrinogen levels except from one analyzer by 50% dilution level. Viscoelastic measurement of fibrin polymerization was reduced at both dilution levels and appeared to reflect the impairment of fibrin polymerization induced by HES 130/0.4 and to a lesser extent human albumin.
CONCLUSION: This study demonstrated that different automated coagulation analyzers revealed significantly different levels of fibrinogen. The presence of colloid plasma expander gave rise to erroneous high levels of fibrinogen returned from some coagulation analyzers employing the method of Clauss.
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Published date: December 2010
Keywords:
Blood Coagulation/drug effects, Blood Preservation/methods, Blood Specimen Collection/methods, Colloids, Cryoprotective Agents/pharmacology, Fibrinogen/analysis, Hematologic Tests/instrumentation, Hemodilution/methods, Humans, Sodium Chloride/pharmacology, Statistics as Topic/methods
Identifiers
Local EPrints ID: 443321
URI: http://eprints.soton.ac.uk/id/eprint/443321
ISSN: 1537-2995
PURE UUID: d74bed5f-690f-4f8f-947c-31255c1ef404
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Date deposited: 20 Aug 2020 16:33
Last modified: 17 Mar 2024 04:02
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Author:
Christian Fenger-Eriksen
Author:
Gary W Moore
Author:
Jørgen Ingerslev
Author:
Benny Sørensen
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