The effects of vasoactive agents, platelet agonists and anticoagulation on thrombelastography

J. Kawasaki, N. Katori, T. Taketomi, K. Terui, K. A. Tanaka

Research output: Contribution to journalArticle

14 Citations (Scopus)

Abstract

Background: Platelet activation is a critical step in primary hemostasis and clot formation. We tested a hypothesis that platelet stimulating effects of vasoactive agents or platelet agonists could be shown using thrombelastography (TEG®) as faster onset or increased clot strength. We further examined if TEG® could be modified to evaluate activated platelets as a reversal of anticoagulation in the presence of partial thrombin inhibition. Methods: Blood samples were obtained from 126 non-cardiac surgical patients. Effects of vasoactive agents on TEG® and aggregometry were examined using epinephrine, norepinephrine, vasopressin, desmopressin acetate, milrinone and olprinone (Experiment I). Platelet agonists (epinephrine, ADP and collagen) were separately tested on TEG® (Experiment II). Effects of platelet agonists (ADP and collagen) on TEG® under anticoagulation in the absence or presence of abciximab were studied (Experiment III). We also tested antiplatelet effects of milrinone and olprinone in the presence of anticoagulants on TEG® (Experiment IV). Results: Neither vasoactive agents nor platelet agonists affected TEG® or aggregometry results except for milrinone and olprinone on aggregometry (Experiment I, II). Platelet agonists facilitated clotting in the presence of anticoagulants (Experiment III). Abciximab-treated platelets still exhibited procoagulant effects in the presence of heparin, while not in the presence of argatroban (Experiment III). Platelet inhibition on the modified TEG® was more extensive with milrinone than olprinone, and it was dose dependent (Experiment IV). Conclusion: Modified TEG® using heparin or argatroban might delineate the procoagulant effects of platelets by adding platelet specific agonist.

Original languageEnglish
Pages (from-to)1237-1244
Number of pages8
JournalActa Anaesthesiologica Scandinavica
Volume51
Issue number9
DOIs
Publication statusPublished - 2007 Oct

Fingerprint

Thrombelastography
Blood Platelets
Milrinone
Adenosine Diphosphate
Anticoagulants
Epinephrine
Heparin
Collagen
Deamino Arginine Vasopressin
Platelet Activation
Hemostasis
Vasopressins
Thrombin
Norepinephrine

Keywords

  • Anticoagulation
  • Milrinone
  • Olprinone
  • Platelet activation
  • Thrombelastography

ASJC Scopus subject areas

  • Anesthesiology and Pain Medicine

Cite this

The effects of vasoactive agents, platelet agonists and anticoagulation on thrombelastography. / Kawasaki, J.; Katori, N.; Taketomi, T.; Terui, K.; Tanaka, K. A.

In: Acta Anaesthesiologica Scandinavica, Vol. 51, No. 9, 10.2007, p. 1237-1244.

Research output: Contribution to journalArticle

Kawasaki, J. ; Katori, N. ; Taketomi, T. ; Terui, K. ; Tanaka, K. A. / The effects of vasoactive agents, platelet agonists and anticoagulation on thrombelastography. In: Acta Anaesthesiologica Scandinavica. 2007 ; Vol. 51, No. 9. pp. 1237-1244.
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abstract = "Background: Platelet activation is a critical step in primary hemostasis and clot formation. We tested a hypothesis that platelet stimulating effects of vasoactive agents or platelet agonists could be shown using thrombelastography (TEG{\circledR}) as faster onset or increased clot strength. We further examined if TEG{\circledR} could be modified to evaluate activated platelets as a reversal of anticoagulation in the presence of partial thrombin inhibition. Methods: Blood samples were obtained from 126 non-cardiac surgical patients. Effects of vasoactive agents on TEG{\circledR} and aggregometry were examined using epinephrine, norepinephrine, vasopressin, desmopressin acetate, milrinone and olprinone (Experiment I). Platelet agonists (epinephrine, ADP and collagen) were separately tested on TEG{\circledR} (Experiment II). Effects of platelet agonists (ADP and collagen) on TEG{\circledR} under anticoagulation in the absence or presence of abciximab were studied (Experiment III). We also tested antiplatelet effects of milrinone and olprinone in the presence of anticoagulants on TEG{\circledR} (Experiment IV). Results: Neither vasoactive agents nor platelet agonists affected TEG{\circledR} or aggregometry results except for milrinone and olprinone on aggregometry (Experiment I, II). Platelet agonists facilitated clotting in the presence of anticoagulants (Experiment III). Abciximab-treated platelets still exhibited procoagulant effects in the presence of heparin, while not in the presence of argatroban (Experiment III). Platelet inhibition on the modified TEG{\circledR} was more extensive with milrinone than olprinone, and it was dose dependent (Experiment IV). Conclusion: Modified TEG{\circledR} using heparin or argatroban might delineate the procoagulant effects of platelets by adding platelet specific agonist.",
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AU - Kawasaki, J.

AU - Katori, N.

AU - Taketomi, T.

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AU - Tanaka, K. A.

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KW - Milrinone

KW - Olprinone

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KW - Thrombelastography

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