Department of Laboratory Medicine and Pathology, Mayo Clinic, Rochester, MN 55905, USA.
Am J Clin Pathol. 2013 Aug;140(2):165-9. doi: 10.1309/AJCPYIQ9JNNSEN4Q.
To compare thromboelastography (TEG) tracings obtained from fresh and citrated whole-blood samples in patients on extracorporeal membrane oxygenation (ECMO) or after cardiopulmonary bypass and in healthy volunteers.
Samples of fresh and citrated whole blood were analyzed for 25 patients and 4 healthy volunteers. Thromboelastography analysis was performed in both plain and heparinase cups.
In 5 of 6 patients on ECMO, use of citrated samples resulted in apparent partial or complete heparin reversal. In TEG tracings from patients following cardiopulmonary bypass, there was a slight hypercoagulable appearance in the citrated sample. No differences were noted between fresh and citrated samples from healthy volunteers whose blood was spiked with heparin.
In some patients on ECMO, use of samples collected in sodium citrate tubes for TEG analysis results in significant artifacts, which could lead to heparin overdosing in these patients.
比较体外膜肺氧合（ECMO）或体外循环后患者及健康志愿者的新鲜及枸橼酸盐全血样本的血栓弹力图（TEG）描记图。
对 25 名患者和 4 名健康志愿者的新鲜和枸橼酸盐全血样本进行分析。TEG 分析分别在普通杯和肝素酶杯中进行。
在 6 名 ECMO 患者中，有 5 名患者使用枸橼酸盐样本导致明显的部分或完全肝素逆转。在体外循环后的患者的 TEG 描记图中，枸橼酸盐样本显示出轻微的高凝状态。在健康志愿者的新鲜和枸橼酸盐样本中，加入肝素的样本之间没有差异。
在一些 ECMO 患者中，使用枸橼酸盐管采集的样本进行 TEG 分析会产生显著的伪影，这可能导致这些患者肝素过量。
