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Vascular Access Device Collection

From Nancy Fabbrini: We have a patient on an argatroban bridge to warfarin. He is a very difficult draw so the service has been drawing blood from the central access device. They have been withdrawing 20 mL of blood before drawing the tube for coagulation testing. Is that sufficient, i.e. do the same “rules” for a line with heparin apply to argatroban? Thank you.

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Pre-surgical Screening Reprise

I’d like to draw your attention to some recent responses to the November 8, 2013 post by Jeanne Isabel entry about pre-surgical screening.

Test to Assess Clotting Status

From our ASCLS Consumer Web Forum: I was wondering if there is any test available to assess the clotting status of someone with factor 5 Leiden genetic disorder to verify if the treatment plan has been effective? If the patient has been on anticoagulants, is there a test to prove that the blood-clotting issue has been resolved or at least under control? Thanks for your help!
George’s response: Thank you for your provocative question. The short answer is no, there is no laboratory test to prove the patient’s thrombotic risk is resolved, or that the anticoagulant treatment is completely effective.

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World Thrombosis Day

Join me in commemorating World Thrombosis Day.

New DOAC Reversal Agents

George, I noticed on Fritsma Factor the question on using Kcentra to reverse DOACs.  I just got this off Medscape on a phase 3 study of an antidote to the  factor Xa inhibitor apixaban. An IV bolus of andexanet alfa immediately and significantly reversed apixaban in 33 healthy volunteers enrolled in the ANNEXA-A study.  The authors also state that Idarucizumab reverses the oral thrombin inhibitor dabagatran etexilate mesylate.  Both have FDA breakthrough status.
Regards,
David L. McGlasson, GS-13
Clinical Research Scientist

KCentra to Reverse DOACs?

From Gabor Varadi, Einstein Healthcare:
Hello George, I would like to ask your opinion about using 4-component prothrombin complex concentrate (PCC) for rivaroxaban and dabigatran-induced life-threatening bleeding. Any scientific data to support using this product? Thank you.

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Quick Question: Platelet Function Poll

From Scott Miller at St. Mary’s of Michigan: Just a note. We use both the PFA-100 and the Verify Now for platelet function testing. I am unable to get the poll to accept more than one response. Scott

Thank you, Scott, we will add your response to the total when we publish the results. Geo

TEG and ROTEM: Reprise

We have two valuable posts on the December 3, 2013 topic of Thromboelastograph (TEG) versus the Rotational Thromboelastometer (ROTEM), asking about transporting platelet function testing specimens through the tube system. I just want to ensure you didn’t miss this useful information.

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