TY - JOUR
T1 - A modified thromboelastographic method for monitoring c7E3 Fab in heparinized patients
AU - Greilich, Philip E.
AU - Alving, Barbara M.
AU - O'Neill, Kathleen L.
AU - Chang, Audrey S.
AU - Reid, Thomas J.
PY - 1997/1/18
Y1 - 1997/1/18
N2 - 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, MA(WB) and MA(PPP), 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 MA(WB) (P < 0.0001) and MA(WB- PPP)) (P < 0.0001). Subtracting the MA(PPP) from MA(WB) 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.
AB - 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, MA(WB) and MA(PPP), 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 MA(WB) (P < 0.0001) and MA(WB- PPP)) (P < 0.0001). Subtracting the MA(PPP) from MA(WB) 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.
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U2 - 10.1097/00000539-199701000-00006
DO - 10.1097/00000539-199701000-00006
M3 - Article
C2 - 8988995
AN - SCOPUS:0031016637
VL - 84
SP - 31
EP - 38
JO - Anesthesia and Analgesia
JF - Anesthesia and Analgesia
SN - 0003-2999
IS - 1
ER -