Clinical use of thrombin generation assays

Binder, Nikolaus B.; Depasse, François; Müeller, Julia; Wissel, Thomas; Schwers, Stephan; Germer, Matthias; Hermes, Björn; Turecek, Peter L.

doi:10.1111/jth.15538

“…More sophisticated integral coagulation tests including the thrombin generation assay, an increasingly recognized tool to evaluate the hemostatic system in platelet-poor plasma, are also utilized to assess COVID-19 coagulopathy [ 89 , 90 ]. Limited knowledge is available on its use and findings in COVID-19 infection, but some reports indicated high thrombin generation in SARS-COV-2 pneumonia despite the use of anticoagulation [ 91 , 92 ].…”

Section: Assessment Of Coagulation In Covid-19mentioning

confidence: 99%

COVID-19 Coagulopathy: From Pathogenesis to Treatment

Alnima

¹

,

Mulder

²

,

Bussel

³

et al. 2022

View full text Add to dashboard Cite

Coronavirus disease 2019 (COVID-19) has emerged as a pandemic at the end of 2019 and continues to exert an unfavourable worldwide health impact on a large proportion of the population. A remarkable feature of COVID-19 disease is the precipitation of a hypercoagulable state, mainly in severe cases, leading to micro- and macrothrombosis, respiratory failure and death. Despite the implementation of various therapeutic regimes, including anticoagulants, a large number of patients suffer from such serious complications. This review aims to describe the current knowledge on the pathophysiology of the coagulation mechanism in COVID-19. We describe the interplay between three important mediators of the disease and how this may lead to a hyperinflammatory and pro-thrombotic state that affects outcome; namely, the endothelium, the immune system and the coagulation system. In line with the hypercoagulability state during COVID-19, we further review on the rare but severe vaccine-induced thrombotic thrombocytopenia. We also summarize and comment on available anticoagulant treatment options and include suggestions for some future treatment considerations for COVID-19 anti-coagulation therapy.

show abstract

“…4a), can be determined, and correlated to clinical phenotypes to investigate coagulation disorders, and measure the effect of anticoagulants. 27 The first TGA was introduced in the 1950s, and involves the activation of coagulation of blood or plasma, followed by a two-stage assay that requires the collection and mixing of sub-samples with fibrinogen (or chromogenic substrates following their availability) at precisely timed intervals (e.g. 1 min) over the course of ~20 min, followed by the quantification of thrombin in each of them.…”

Section: Automated Sars-cov-2-specific Saliva Antibody Detection Assaymentioning

confidence: 99%

Microfluidic Chain Reaction of Structurally Programmed Capillary Flow Events

Yafia

¹

,

Ymbern

²

,

Olanrewaju

³

et al. 2022

Preprint

View full text Add to dashboard Cite

Chain reactions are characterized by initiation, propagation and termination, are stochastic at microscopic scales and underlie vital chemical (e.g. combustion engines), nuclear and biotechnological (e.g. polymerase chain reaction) applications.1-5 At macroscopic scales, chain reactions are deterministic and limited to applications for entertainment and art such as falling domino and Rube Goldberg machines. Appositely, the microfluidic lab-on-a-chips (also called a micro total analysis system),6,7 was envisioned as an integrated chip, akin to microelectronic integrated circuits, yet in practice remain dependent on cumbersome peripherals, connections, and a computer for automation.8-11 Capillary microfluidics integrate energy supply and flow control onto a single chip by using capillary phenomena, but programmability remains rudimentary with at most a handful (eight) operations possible.12-19 Here we introduce the microfluidic chain reaction (MCR) as the conditional, structurally programmed propagation of capillary flow events. Monolithic chips integrating a MCR are 3D printed, and powered by the free-energy of a paper pump, autonomously execute liquid handling algorithms step-by-step. With MCR, we automated (i) the sequential release of 300 aliquots across chained, interconnected chips, (ii) a protocol for SARS-CoV-2 antibodies detection in saliva, and (iii) a thrombin generation assay by continuous subsampling and analysis of coagulation-activated plasma with parallel operations including timers, iterative cycles of synchronous flow and stop-flow operations. MCRs are untethered from and unencumbered by peripherals, encode programs structurally in situ, and can form frugal, versatile, bona fide lab-on-a-chip with wide-ranging applications in liquid handling and point-of-care diagnostics.

show abstract

“…4a), can be determined, and correlated to clinical phenotypes to investigate coagulation disorders, and measure the effect of anticoagulants. 25 The first TGA was introduced in the 1950s, and involves the activation of coagulation of blood or plasma, followed by a two-stage assay that requires the collection and mixing of sub-samples with fibrinogen (or chromogenic substrates following their availability) at precisely timed intervals (e.g. 1 min) over the course of ~20 min, followed by the quantification of thrombin in each of them.…”

Section: Automated Sars-cov-2-specific Saliva Antibody Detection Assaymentioning

confidence: 99%

Microfluidic Chain Reaction: Conditional, Structurally Programmed Propagation of Capillary Flow Events

Yafia

¹

,

Ymbern

²

,

Olanrewaju

³

et al. 2021

Preprint

0

View full text Add to dashboard Cite

Chain reactions are characterized by initiation, propagation and termination, are stochastic at microscopic scales and underlie vital chemical (e.g. combustion engines), nuclear and biotechnological (e.g. polymerase chain reaction) applications.1-5 At macroscopic scales, chain reactions are deterministic and limited to applications for entertainment and art such as falling domino and Rube Goldberg machines. Appositely, the microfluidic lab-on-a-chips (also called a micro total analysis system),6,7 was envisioned as an integrated chip, akin to microelectronic integrated circuits, yet in practice remain dependent on cumbersome peripherals, connections, and a computer for automation.8-11 Capillary microfluidics integrate energy supply and flow control onto a single chip by using capillary phenomena, but programmability remains rudimentary with at most a handful (eight) operations possible.12-19 Here we introduce the microfluidic chain reaction (MCR) as the conditional, structurally programmed propagation of capillary flow events. Monolithic chips integrating a MCR are 3D printed, and powered by the free-energy of a paper pump, autonomously execute liquid handling algorithms step-by-step. With MCR, we automated (i) the sequential release of 300 aliquots across chained, interconnected chips, (ii) a protocol for SARS-CoV-2 antibodies detection in saliva, and (iii) a thrombin generation assay by continuous subsampling and analysis of coagulation-activated plasma with parallel operations including timers, iterative cycles of synchronous flow and stop-flow operations. MCRs are untethered from and unencumbered by peripherals, encode programs structurally in situ, and can form frugal, versatile, bona fide lab-on-a-chip with wide-ranging applications in liquid handling and point-of-care diagnostics.

show abstract

Clinical use of thrombin generation assays

Cited by 56 publications

References 99 publications

COVID-19 Coagulopathy: From Pathogenesis to Treatment

COVID-19 Coagulopathy: From Pathogenesis to Treatment

Microfluidic Chain Reaction of Structurally Programmed Capillary Flow Events

Microfluidic Chain Reaction: Conditional, Structurally Programmed Propagation of Capillary Flow Events

Contact Info

Product

Resources

About