|
Anesthesia & Analgesia, Vol 84, 31-38, Copyright © 1997 by International Anesthesia Research Society
A modified thromboelastographic method for monitoring c7E3 Fab in heparinized patients
PE Greilich, BM Alving, KL O'Neill, AS Chang and TJ Reid
Anesthesia and Operative Services, Walter Reed Army Medical Center, Washington, DC, USA.
The monoclonal antibody, c7E3 Fab, binds to the platelet surface fibrinogen
receptor (GPIIb/IIIa), inhibiting platelet aggregation and clot retraction.
We performed an in vitro study to assess the ability of a modification of
the thromboelastograph (MTEG) to detect inhibition of clot strength by c7E3
Fab and its reversal with platelet-rich plasma (PRP). In the modified assay
(MTEG), thrombin was added to whole blood (WB) and platelet-poor plasma
(PPP) and the resultant maximum amplitude (MA) was measured, MAWB and
MAPPP, respectively. Anticoagulated blood samples from 17 patients
scheduled for cardiac surgery were collected for a dose response (Part I; n
= 5) and c7E3 Fab reversal (Part II; n = 12) study. Clot strength was
reduced in a dose-dependent manner by c7E3 Fab. Ecteola cellulose
effectively reversed the effect of heparin on the thrombin time and the
addition of PRP significantly increased the MAWB (P < 0.0001) and
MAWP-PPP (P < 0.0001). Subtracting the MAPPP from MAWB significantly
magnified the response of MA to the addition of c7E3 Fab (P = 0.002) and
its reversal with PRP (P = 0.005). This in vitro study indicates that the
MTEG is a responsive assay demonstrating that inhibition by the
antiplatelet c7E3 Fab is reversible with PRP.
This article has been cited by other articles:
|
|
|
|
 
R. S. Barua, F. Sy, S. Srikanth, G. Huang, U. Javed, C. Buhari, D. Margosan, and J. A. Ambrose
Effects of Cigarette Smoke Exposure on Clot Dynamics and Fibrin Structure: An Ex Vivo Investigation
Arterioscler Thromb Vasc Biol,
January 1, 2010;
30(1):
75 - 79.
[Abstract]
[Full Text]
[PDF]
|
|
|
|
|
|
|
B. E. Miller, S. R. Tosone, N. A. Guzzetta, J. L. Miller, and K. K. Brosius
Fibrinogen in Children Undergoing Cardiac Surgery: Is It Effective?
Anesth. Analg.,
November 1, 2004;
99(5):
1341 - 1346.
[Abstract]
[Full Text]
[PDF]
|
|
|
|
|
|
|
K. B. Johnson, J. D. Swenson, T. D. Egan, R. Jarrett, and M. Johnson
Midazolam and Remifentanil by Bolus Injection for Intensely Stimulating Procedures of Brief Duration: Experience with Awake Laryngoscopy
Anesth. Analg.,
May 1, 2002;
94(5):
1241 - 1243.
[Abstract]
[Full Text]
[PDF]
|
|
|
|
|
|
|
L. Shore-Lesserson
Monitoring the Hematologic Complications of Cardiopulmonary Bypass
Seminars in Cardiothoracic and Vascular Anesthesia,
September 1, 2001;
5(3):
207 - 216.
[Abstract]
[PDF]
|
|
|
|
|
|
|
E. Mahla, T. Lang, M. N. Vicenzi, G. Werkgartner, R. Maier, C. Probst, and H. Metzler
Thromboelastography for Monitoring Prolonged Hypercoagulability After Major Abdominal Surgery
Anesth. Analg.,
March 1, 2001;
92(3):
572 - 577.
[Abstract]
[Full Text]
[PDF]
|
|
|
|
|
|
|
S. C. Silvestry and P. K. Smith
Current status of cardiac surgery in the abciximab-treated patient
Ann. Thorac. Surg.,
August 1, 2000;
70(2):
S12 - 19.
[Abstract]
[Full Text]
[PDF]
|
|
|
|
|
|
|
V. N. R. Gottumukkala, S. K. Sharma, and J. Philip
Assessing Platelet and Fibrinogen Contribution to Clot Strength Using Modified Thromboelastography in Pregnant Women
Anesth. Analg.,
December 1, 1999;
89(6):
1453 - 1453.
[Abstract]
[Full Text]
[PDF]
|
|
|
|
|
|
|
S. C. Kettner, O. P. Panzer, S. A. Kozek, F. A. Seibt, B. Stoiser, J. Kofler, G. J. Locker, and M. Zimpfer
Use of abciximab-Modified Thrombelastography in Patients Undergoing Cardiac Surgery
Anesth. Analg.,
September 1, 1999;
89(3):
580 - 580.
[Abstract]
[Full Text]
[PDF]
|
|
|
|
|
|
|
B. S. Coller
Monitoring Platelet GP IIb/IIIa Antagonist Therapy
Circulation,
January 13, 1998;
97(1):
5 - 9.
[Full Text]
[PDF]
|
|
|
|
