Effect of platelet count and hematocrit on the coagulability of heparinized blood.

The coagulability of heparinized blood is shown to be a function of platelet and red cell concentrations. Thrombelastrographic tests were conducted on celite-activated fabricated whole blood samples with heparin concentrations ranging from zero to 1.46 units per ml of plasma, hematocrits from zero to 50% and platelet counts from zero to 300,000/mm3. The thrombelastograph provides three useful parameters of coagulability in native and heparinized blood: clot time, rate of clot stiffening and final clot stiffness. Of these, only the clot time is determined with the common clotting tests, while the rate and final clot stiffness are measures of clot quality that are found to be particularly sensitive to thrombocytopenia. The test results indicate (i) increases of platelet concentration produce the expected decrease in clot time, increase in rate of stiffening, and increase in final stiffness; (ii) increases of the red cell concentration from zero to 20% hematocrit, produce nonlinear increases in clotability, while further increases beyond 20% hematocrit produce no additional effects if the heparin concentration is less than 1.2 units/ml. Quantative relations are derived between the thrombelastographic variables, heparin concentration, and platelet concentration for those samples with hematocrits greater than 20%. These data indicate further experiments for the study of possible interaction between cellular blood elements and heparin.