title: D-phenylalanyl-L-prolyl-L-arginine chloromethyl ketone (PPACK): alternative anticoagulant to heparin salts for blood gas and electrolyte specimens.
abstract: D-Phenylalanyl-L-prolyl-L-arginine chloromethyl ketone (PPACK), a selective thrombin inhibitor, was evaluated as an alternative anticoagulant to lithium heparin (LiHep) for blood gas and whole-blood electrolyte analyses. Initial studies in serum revealed a negative proportional bias for ionized calcium (iCa) concentration measured in the range of increasing concentrations of LiHep (-0.02 mmol/L iCa per 33 kIU/L), whereas no bias in iCa concentration was detected with increasing concentrations of PPACK. No anticoagulant-dependent changes in serum sodium, potassium, chloride, glucose, lactate, ionized magnesium, or pH were detected with either PPACK or LiHep. Similarly, no bias was observed in the measurement of whole-blood PO2, PCO2, pH, or sodium or potassium concentrations with either anticoagulant. Whole blood anticoagulated with LiHep (33 kIU/L) demonstrated a consistent -0.06 +/- 0.01 mmol/L bias for iCa compared with a nonanticoagulated whole-blood control. In comparison, no iCa bias was observed with PPACK-anticoagulated whole blood. We conclude that PPACK has ideal bias-free properties as an anticoagulant in analyses for blood gases, electrolytes, and iCa.
authors.affiliation: Department of Physiology, College of Medicine, University of Saskatchewan, Saskatoon, Canada.
authors.forename: M E
authors.initials: ME
authors.lastname: Lyon
authors.forename: J S
authors.initials: JS
authors.lastname: Fine
authors.forename: P J
authors.initials: PJ
authors.lastname: Henderson
authors.forename: A W
authors.initials: AW
authors.lastname: Lyon
mesh_terms: D000590:Amino Acid Chloromethyl Ketones; D000595:Amino Acid Sequence; D000925:Anticoagulants; D001774:Blood Chemical Analysis; D001784:Blood Gas Analysis; D001786:Blood Glucose / Q000032:analysis; D002118:Calcium / Q000097:blood; D002712:Chlorides / Q000097:blood; D004573:Electrolytes / Q000097:blood*; D006493:Heparin; D006801:Humans; D006863:Hydrogen-Ion Concentration; D007773:Lactates / Q000097:blood; D019344:Lactic Acid; D008094:Lithium; D008274:Magnesium / Q000097:blood; D008969:Molecular Sequence Data; D011188:Potassium / Q000097:blood; D012964:Sodium / Q000097:blood
chemical_list: D000590:Amino Acid Chloromethyl Ketones; D000925:Anticoagulants; D001786:Blood Glucose; D002712:Chlorides; D004573:Electrolytes; D007773:Lactates; D019344:Lactic Acid; D006493:Heparin; D008094:Lithium; D012964:Sodium; D008274:Magnesium; C040308:phenylalanyl-prolyl-arginine-chloromethyl ketone; D011188:Potassium; D002118:Calcium