The effect of dabigatran on the kaolin-activated whole blood thromboelastogram.
Dabigatran is a direct thrombin inhibitor, which is increasingly likely to be encountered in patients presenting for surgery. This study examines whether there is a consistent effect of dabigatran on the thromboelastogram (TEG) and whether this correlates with the effects of dabigatran on traditional coagulation parameters. Twenty patients taking dabigatran had blood sampled for kaolin-activated whole blood TEG analysis and routine coagulation testing. There was a statistically significant correlation between thrombin clotting time (TCT) and R-time (R=0.77,P=0.0001) and between activated partial thromboplastin time (APTT) and R-time (R=0.68,P=0.0013), but not between TCT and alpha-angle (R= -0.4232,P=0.071). Despite the moderate to high correlation between the TEG R-time and the TCT and APTT, there appeared to be no consistent effect of dabigatran on the TEG. These findings suggest that use of kaolin-activated whole blood TEG does not add additional benefit to traditional coagulation tests when monitoring the effect of dabigatran.
Anaesthesia Registrar, Department of Anaesthesia, Waikato Hospital, Hamilton, New Zealand.
A
A
'Aho
Specialist Anaesthetist, Department of Anaesthesia, Waikato Hospital, Hamilton, New Zealand.
K
K
Byrne
D000368:Aged; D000369:Aged, 80 and over; D000991:Antithrombins / Q000494:pharmacology*; D000069604:Dabigatran / Q000494:pharmacology*; D005260:Female; D006801:Humans; D007616:Kaolin / Q000494:pharmacology*; D008297:Male; D008875:Middle Aged; D013916:Thrombelastography; D013918:Thrombin Time
D000991:Antithrombins; D007616:Kaolin; D000069604:Dabigatran
Dabigatran, thromboelastography