Objective:Low-molecular-weight heparins (LMWHs) are commonly used to prevent and manage postoperative thromboembolism. In general, monitoring of anticoagulant activity by anti-Xa testing is not done properly. Thromboelastography (TEG) evaluates the viscoelastic properties of blood during coagulation. The clinical application of TEG variables in monitoring LMWH treatment is not yet well defined.Methods:This prospective study was designed to systematically examine the correlation between anti-Xa and basic TEG parameters in monitoring LMWH treatment. We furthermore evaluated for the first time the usefulness of a composite TEG parameter, coagulation index (CI). Thirty patients undergoing unilateral or bilateral total knee replacement, admitted to the intensive care unit on a therapeutic dosage of subcutaneous enoxaparin (30-mg injections administered twice daily), were included into the study. TEG parameters and anti-Xa levels were measures at baseline and 4, 12, and 24 hours after the injection.Results:This study demonstrates a significant correlation between CI and plasma anti-Xa activity in surgical patients treated with enoxaparin. Although the correlation was significant between r time and anti-Xa level only at Hour 4, CI was significant for each time interval (p<0.05). CI increased immediately after T0, peaking at Hour 4, and remained elevated (relative to baseline) at Hour 24 but still did not return to admission levels.Conclusion:The current study may be an important first step in order to use CI to measure LMWH activity. Meanwhile, the value and usefulness of TEG in predicting bleeding or thrombotic complications following major orthopedic surgery merit further investigation.

No abstract

Objective: Accurate, reliable laboratory reference ranges are essential for effective clinical evaluation and monitoring. We present robust reference ranges established for hematology parameters using the Sysmex XT2000i analyzer.Methods: Blood samples were taken from 17409 healthy adults (19 to 49 years, 51.4% men and 48.6% women) and routine hematology analysis performed. Patients were assessed as healthy on the basis of a medical history and routine medical examinations. Serum hematinic assays (vitamin B12, folate, iron and ferritin) were also analyzed in order to exclude the potential anemia existence.Results: There was a statistically significant difference (p<0.001) between men and women, with the former showing higher CBC values, except WBC, neutrophil and platelet counts compared to females. Several differences were observed when compared to previously established values from Turkey, most notably in leucocytes and platelets. Our findings for CBC parameters, except leucocyte count and MCV are in general agreement with previously published data from more limited trials undertaken in other countries. Conclusions:In spite of the uncontrolled factors influencing hematological values, this study permitted to establish the new hematological reference values in Turkey, especially living near sea level. In the absence of previously detailed investigated hematological reference values in Turkey, we offered to use these results for clinical management of Turkish patients and interpretations of laboratory data for research purpose. J Clin Exp Invest 2014; 5 (4): 548-552

Correlation between the two clot-detection systems was maintained even when measuring turbid samples (R² ≥ 0.97 for two tests).

No abstract