Use of an Automated Coagulation Analyzer to Perform Heparin Neutralization With Polybrene in Blood Samples for Routine Coagulation Testing: Practical, Rapid, and Inexpensive

Abstract

Context.-Heparin contamination in blood samples may cause false prolongation of activated partial thromboplastin time (aPTT) and prothrombin time results. Polybrene can neutralize heparin, but it affects coagulation by itself.Objectives.-To determine the optimal concentration of polybrene to neutralize heparin, to determine the suitable sequence of reagents for the neutralization method performed on the analyzer at the same time as prothrombin time and aPTT testing, and to detect the heparin contamination in blood samples for coagulation tests in our hospital using this method.Design.-Various concentrations of heparin were added to 10 normal and 76 abnormal plasma samples to study the efficacy of polybrene. Two programs of reagent sequencing for aPTT with polybrene performed on the analyzer were tested. Samples suspected of heparin contamination according to our criteria were selected for neutralization during a 3-month period.Results.-The optimal final concentration of polybrene was 25 lg/mL. Polybrene should be added after the aPTT reagent to minimize its interference effect. Even though results of prothrombin time and aPTT after neutralization did not equal those before the spike of heparin, the differences might not be clinically significant. Eighty-one of 4921 samples (1.6%) were selected for aPTT with the neutralization method, and the detection rate of heparin contamination was 84% (68 of 81), giving an overall incidence of 1.4% (68 of 4921).Conclusions.-This method is inexpensive and can be performed rapidly with prothrombin time and aPTT on the automated analyzer, which makes it easy to practice with no need for extra plasma volumes.

Thromboelastography: a comparison of polybrene and heparinase for the inactivation of heparin

“…По этой концентрации определяли концентрацию гепарина в образце крови [15,16]. Более того, разработаны даже автоматические анализаторы, в которых использовали полибрен для определения концентрации гепарина в крови [17]. В 60-е годы прошлого века полибрен начали применять не только как лабораторный реактив, но и как лечебный препарат в клинической практике для нейтрализации гепарина [18].…”

Study of in vitro thrombin generation after neutralization of heparin

“…Thrombin generation was studied with the ST Genesia device (Diagnostica Stago, Asnières‐sur‐Seine, France) using either STG‐DrugScreen (tissue factor (TF) concentration in the high picomolar range; generally used to assess TG in anticoagulated patients) or STG‐ThromboScreen (lower picomolar TF concentration than STG‐DrugScreen; generally used to assess thrombotic states) reagent (Stago) as previously described 13‐15 . Briefly, calibration (using the dedicated calibrator STG‐ThrombiCal) and internal quality controls (provided with STG‐DrugScreen and STG‐ThromboScreen kits) were performed before each test series.…”

Simultaneous estimation of vitamin K1 and heparin with low limit of detection using cascaded channels fiber optic surface plasmon resonance

“…Due to the imbalance of the reaction, repulsion occurs amongst VK 1 molecules which reduces the increase of the evanescent field and hence the sensitivity. Similarly, in the case of heparin sensing, polybrene neutralizes heparin involved in chemical reactions/interactions until and unless the molecules of the two constituents remain balanced in the reaction (Montalescot et al, 1990;Tientadakul et al, 2013). Increase in the concentration of heparin increases the imbalance of the reaction and repulsive force roles amongst the heparin molecules as a result the increase in evanescent field decreases and hence the sensitivity.…”

“…However, these should be present in some specific ratio otherwise MWCNTs can have some adverse effects like pathogenicity activity (Poland et al, 2008). Polybrene has been used for the sensing of heparin (Liu et al, 2015;Zhang et al, 2015) because polybrene neutralizes heparin involving chemical reactions/interactions (Montalescot et al, 1990;Tientadakul et al, 2013). In the proposed sensor for heparin sensing, ZnO has been introduced in the form of shell with polybrene as a central core because it has been recently reported by us that ZnO along with the sensing material increases the evanescent field and consequently the sensing performance of the SPR based sensor (Tabassum and Gupta, 2015).…”