title: Plasma and cerebral spinal fluid tranexamic acid quantitation in cardiopulmonary bypass patients.
abstract: A method for the determination of tranexamic acid (TXA) in human plasma and cerebral spinal fluid (CSF) was developed. Analyses were performed by ultra performance liquid chromatography with tandem mass spectrometry detection (UPLC-MS/MS) using ɛ-aminocaproic acid (ACA) as an internal standard. TXA and ACA were extracted from a 50 μL sample of plasma or CSF using a methanol protein crash protocol, and chromatographic separation was performed on an ACQUITY™ TQD mass spectrometer using a UPLC C18 BEH 1.7 μm column with a water and methanol gradient containing 0.1% formic acid. The detection and quantitation was performed by positive ion electrospray ionization using the multiple reaction monitoring (MRM) mode. The method was linear over the concentration range of 0.1-10.0 μg/mL, with lower limit of quantitation of 0.1 μg/mL for TXA. The intra- and inter-assay precision was less than 12% and 13% respectively at the plasma and CSF TXA concentrations tested. The present method provides a relatively simple and sensitive assay with short turn-around-time. The method has been successfully applied to assess the plasma and CSF concentrations of tranexamic acid achieved with only one dosing regimen of tranexamic acid in patients undergoing cardiopulmonary bypass surgery (CPB).
authors.affiliation: Department of Pathology and Laboratory Medicine, Emory University School of Medicine, Atlanta, GA 30322, USA.
authors.forename: Charbel
authors.initials: C
authors.lastname: Abou-Diwan
authors.forename: Roman M
authors.initials: RM
authors.lastname: Sniecinski
authors.forename: Fania
authors.initials: F
authors.lastname: Szlam
authors.forename: James C
authors.initials: JC
authors.lastname: Ritchie
authors.forename: Jeanne M
authors.initials: JM
authors.lastname: Rhea
authors.forename: Kenichi A
authors.initials: KA
authors.lastname: Tanaka
authors.forename: Ross J
authors.initials: RJ
authors.lastname: Molinaro
mesh_terms: D000933:Antifibrinolytic Agents / Q000097:blood* / Q000134:cerebrospinal fluid* / Q000493:pharmacokinetics; D002315:Cardiopulmonary Bypass; D002851:Chromatography, High Pressure Liquid; D006454:Hemoglobins / Q000032:analysis; D006801:Humans; D012680:Sensitivity and Specificity; D021241:Spectrometry, Mass, Electrospray Ionization; D053719:Tandem Mass Spectrometry; D014148:Tranexamic Acid / Q000097:blood* / Q000134:cerebrospinal fluid* / Q000493:pharmacokinetics
chemical_list: D000933:Antifibrinolytic Agents; D006454:Hemoglobins; D014148:Tranexamic Acid