title: Simple clotting test to detect procoagulant abdominal swabs.
abstract: During surgical procedures, abdominal swabs are routinely used to adsorb blood from the operation field and for the retention of tissues and organs. Due to the material characteristics, abdominal swabs exhibit a slight procoagulant activity, which is usually desirable and mostly harmless. However, during cardiac surgery with heart-lung machine (HLM) support, abnormal clot formation may result in life-threatening thromboembolic complications. Therefore, a simple clotting test (SCT) allowing in vitro detection of abdominal swabs with elevated hypercoagulant potency in the presence of heparinized human blood was developed and validated. In order to establish a SCT, heparinized human blood from 100 donors was incubated with five different cotton abdominal swabs for 30 min at 37 °C and then macroscopically analyzed. In a second study, 10 other swabs were screened with the established SCT (n=11) to confirm its suitability. Scanning electron microscopy, measurements of activated clotting times and thrombin-antithrombin were further performed. In the SCT, the results are dichotomized as negative (no detectable blood clot) and positive (blood clot formation). In the first study, three of the five tested abdominal swabs exhibited hypercoagulant potency in at least 25% of the donors. Calculations using the binomial distribution showed that blood of 11 donors is needed for routine testing with the SCT, which was confirmed in the second study using another 10 swabs. The established SCT can be used for detection of abdominal swabs with an elevated procoagulant potency, thereby minimizing the risk of thromboembolic complications during cardiac surgery with HLM support.
authors: Clinical Research Laboratory, Department of Thoracic, Cardiac and Vascular Surgery, University Hospital Tuebingen, Tuebingen University, Calwerstr. 7/1, 72076, Tūbingen, Germany.
authors: Stefanie
authors: S
authors: Krajewski
authors: Tanja
authors: T
authors: Nathan
authors: Bernd
authors: B
authors: Neumann
authors: Sebastian
authors: S
authors: Hoffmann
authors: Martin
authors: M
authors: Abel
authors: Annette
authors: A
authors: Koggel
authors: Christian
authors: C
authors: Schlensak
authors: Hans P
authors: HP
authors: Wendel
mesh_terms: D000005:Abdomen; D001777:Blood Coagulation / Q000502:physiology*; D001780:Blood Coagulation Tests / Q000295:instrumentation* / Q000379:methods*; D004867:Equipment Design; D019544:Equipment Failure Analysis / Q000295:instrumentation* / Q000379:methods*; D006801:Humans; D015503:Surgical Sponges