Correlation of hematocrit, platelet concentration, and plasma coagulation factors with results of thromboelastometry in canine whole blood samples

Stephanie A. Smith Department of Biochemistry, College of Medicine, College of Veterinary Medicine, University of Illinois, Urbana, IL 61802.

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Maureen A. McMichael Department of Veterinary Clinical Sciences, College of Veterinary Medicine, University of Illinois, Urbana, IL 61802.

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Shir Gilor Department of Pathobiology, College of Veterinary Medicine, University of Illinois, Urbana, IL 61802.

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Alyssa J. Galligan Department of Veterinary Clinical Sciences, College of Veterinary Medicine, University of Illinois, Urbana, IL 61802.

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Crystal M. Hoh Department of Veterinary Clinical Sciences, College of Veterinary Medicine, University of Illinois, Urbana, IL 61802.

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Abstract

Objective—To evaluate the components of canine whole blood samples that contribute to results of thromboelastometry (TEM).

Animals—127 healthy dogs.

Procedures—For each dog, a blood sample was collected from a jugular vein into tubes containing no anticoagulant, EDTA, or citrate anticoagulant. Citrated whole blood samples underwent TEM with tissue factor and TEM with ellagic acid. Indicators of RBC mass and platelet concentration were evaluated, and plasma coagulation tests were performed; data obtained were compared with results of TEM. For technical reasons, samples were not available from all dogs for all tests.

Results—Coagulation time was correlated with concentrations of primarily extrinsic pathway coagulation factors for TEM with tissue factor and with most factors via TEM with ellagic acid. Clot formation time, α angle, and maximum clot firmness were highly correlated with fibrinogen and platelet concentrations and some individual factor concentrations. Sample Hct was strongly correlated with most measured variables; low Hct was associated with relative hypercoagulability, and high Hct was associated with relative hypocoagulability.

Conclusions and Clinical Relevance—For TEM of canine blood samples, coagulation time was primarily a function of coagulation factor concentrations, whereas other variables were dependent on platelet and fibrinogen concentrations. Sample Hct strongly influenced the results of TEM, likely because RBCs act as a diluent for plasma coagulation factors. Thromboelastometry appeared to be affected by abnormalities of coagulation factors, platelet concentrations, and RBC mass. In samples from anemic patients, results of TEM indicative of hypercoagulability may be artifactual because of low RBC mass.

Abstract

Objective—To evaluate the components of canine whole blood samples that contribute to results of thromboelastometry (TEM).

Animals—127 healthy dogs.

Procedures—For each dog, a blood sample was collected from a jugular vein into tubes containing no anticoagulant, EDTA, or citrate anticoagulant. Citrated whole blood samples underwent TEM with tissue factor and TEM with ellagic acid. Indicators of RBC mass and platelet concentration were evaluated, and plasma coagulation tests were performed; data obtained were compared with results of TEM. For technical reasons, samples were not available from all dogs for all tests.

Results—Coagulation time was correlated with concentrations of primarily extrinsic pathway coagulation factors for TEM with tissue factor and with most factors via TEM with ellagic acid. Clot formation time, α angle, and maximum clot firmness were highly correlated with fibrinogen and platelet concentrations and some individual factor concentrations. Sample Hct was strongly correlated with most measured variables; low Hct was associated with relative hypercoagulability, and high Hct was associated with relative hypocoagulability.

Conclusions and Clinical Relevance—For TEM of canine blood samples, coagulation time was primarily a function of coagulation factor concentrations, whereas other variables were dependent on platelet and fibrinogen concentrations. Sample Hct strongly influenced the results of TEM, likely because RBCs act as a diluent for plasma coagulation factors. Thromboelastometry appeared to be affected by abnormalities of coagulation factors, platelet concentrations, and RBC mass. In samples from anemic patients, results of TEM indicative of hypercoagulability may be artifactual because of low RBC mass.

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