Thrombelastography in 26 healthy horses with and without activation by recombinant human tissue factor.
Abstract: To develop a standardized technique for thrombelastography (TEG) analysis in healthy adult horses, with and without the ex vivo addition of tissue factor (TF) as an activator. To determine reference intervals for TEG parameters in the horse, and to determine if traditional coagulation tests correlate with TEG. Methods: Prospective, observational. Methods: Veterinary teaching hospital. Methods: Twenty-six healthy adult horses. Methods: None. Results: Thrombelastography with (TF-TEG) and without (TEG) the addition of TF performed by 4 operators. Coagulation profiles (prothrombin time, activated partial thromboplastin time, platelet count, fibrinogen, antithrombin, and fibrinogen degradation products) were assessed in a subset of horses. Mean values (SD) for TEG parameters in healthy horses were: reaction time (R)=17.0 minutes (3.0 min), K time (K)=5.8 minutes (2.3 min), clotting rate (Ang)=42 degrees (14 degrees ), maximum clot strength (maximum amplitude [MA])=60.3 mm (5.7 mm), CL30=97.0% (2.0%), LY30=0.8% (0.6%), CL60=92% (5.9%), LY60=3.2% (2.5%). Mean values (SD) for TF-TEG parameters were: R-TF=6.6 minutes (1.4 min), K-TF=3.1 minutes (1.0 min), Ang-TF=50.9 degrees (9 degrees ), MA-TF=62.3 mm (5.1 mm), CL30-TF=97.8% (1.6%), LY30-TF=0.6% (0.5%), CL60-TF=90.8% (4.2%), and LY60-TF=3.6% (1.9%). The addition of TF decreased R and K and increased Ang. TF-TEG had a narrower SD for R, K, Ang, CL60 and LY60 compared with TEG. Interoperator differences were reduced by the addition of TF. Regression analysis indicated a positive relationship between MA and fibrinogen concentrations (P=0.02) and R-TF time and prothrombin time (P=0.03). Conclusions: TF-TEG using the described protocol may minimize variability in data obtained across institutions or users. However, due to the variability associated with different operators, it is recommended that each laboratory set up individual reference intervals with the personnel who will perform the assay, and that the assay protocols and data obtained are compared on a regular basis.
Publication Date: 2009-08-21 PubMed ID: 19691590DOI: 10.1111/j.1476-4431.2008.00381.xGoogle Scholar: Lookup
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- Journal Article
- Research Support
- Non-U.S. Gov't
Summary
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This study develops a technique for measuring blood clotting in healthy adult horses both with and without the addition of a tissue factor. The results obtained can help establish baseline reference intervals for clotting parameters in horses and determine the correlation between traditional coagulation tests and thrombelastography.
Objectives of the Study
- The main focus of the study was to develop a standardized process of testing blood coagulation through Thrombelastography (TEG) analysis in healthy adult horses, with and without the involvement of tissue factor (TF) as an activator.
- The study also aimed to establish reference intervals for TEG parameters in horses to facilitate future research and diagnoses.
- The researchers wanted to explore if traditional blood coagulation tests had any correlation with this enhanced TEG method.
Methodology of the Study
- The study was prospective and observational, carried out at a veterinary teaching hospital.
- The total subjects in this study were 26 healthy adult horses.
- The TEG analysis was performed both with and without the addition of TF by four different operators.
- Subsequently, coagulation profiles in these horses were assessed, including prothrombin time, activated partial thromboplastin time, platelet count, fibrinogen, antithrombin, and fibrinogen degradation products.
Findings of the Study
- The study deduced several mean values for TEG parameters in healthy horses, such as reaction time, K time, clotting rate, maximum clot strength, percentage of clot lysis at 30 and 60 minutes and likewise for TEG parameters with tissue factor (TF-TEG).
- The inclusion of TF resulted in decreased R and K and increased clotting rate (Ang).
- The consistency (standard deviation) for various TEG parameters (R, K, Ang, clot lysis at 60 minutes) was better (narrower) with the addition of TF, indicating less variability in results. Similarly, interoperator differences were reduced with the use of TF.
- A positive connection was identified between maximum clot strength (MA) and fibrinogen concentrations and R-TF time and prothrombin time.
Conclusions and Recommendations
- Using TF-TEG as per the protocol described in the study may reduce variability across different institutions or users.
- However, due to operator-specific variability, it is recommended to have each laboratory set up individual reference intervals with the assay performing personnel.
- Moreover, the assay protocols and data obtained should be compared and scrutinized regularly to ensure consistency and accuracy.
Cite This Article
APA
Epstein KL, Brainard BM, Lopes MA, Barton MH, Moore JN.
(2009).
Thrombelastography in 26 healthy horses with and without activation by recombinant human tissue factor.
J Vet Emerg Crit Care (San Antonio), 19(1), 96-101.
https://doi.org/10.1111/j.1476-4431.2008.00381.x Publication
Researcher Affiliations
- Department of Large Animal Medicine, University of Georgia, Athens, GA, USA. kirae@uga.edu
MeSH Terms
- Animals
- Female
- Horses / blood
- Humans
- Male
- Recombinant Proteins
- Sensitivity and Specificity
- Thrombelastography / methods
- Thrombelastography / veterinary
- Thromboplastin
Citations
This article has been cited 4 times.- Irwin RM, Bonassar LJ, Cohen I, Matuska AM, Commins J, Cole B, Fortier LA. The clot thickens: Autologous and allogeneic fibrin sealants are mechanically equivalent in an ex vivo model of cartilage repair.. PLoS One 2019;14(11):e0224756.
- Bae J, Kim H, Kim W, Kim S, Park J, Jung DI, Yu D. Therapeutic monitoring of rivaroxaban in dogs using thromboelastography and prothrombin time.. J Vet Intern Med 2019 May;33(3):1322-1330.
- Barratclough A, Hanel R, Stacy NI, Ruterbories LK, Christiansen E, Harms CA. Establishing a protocol for thromboelastography in sea turtles.. Vet Rec Open 2018;5(1):e000240.
- Fong DL, Ha JC, Hotchkiss CE. Thromboelastography values from pigtail macaques ( Macaca nemestrina): effects of age and sex.. J Am Assoc Lab Anim Sci 2012 Jan;51(1):94-100.
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