• J Clin Monit Comput · Dec 2024

    Clot formation risk in the clearing fluid after arterial catheter blood sampling: coagulation factors consumption over time - a prospective pilot study.

    • Jerome E Dauvergne, Elodie Boissier, Bertrand Rozec, Karim Lakhal, and Damien Muller.
    • Nantes Université, CHU Nantes, INSERM, Service d'anesthésie-réanimation, Hôpital Laënnec, CIC 1413, Nantes, F-44000, France. jerome.dauvergne@chu-nantes.fr.
    • J Clin Monit Comput. 2024 Dec 12.

    AbstractAfter blood sampling from an arterial catheter, the reinjection of the clearing fluid (a mixture of saline solution and blood) is proposed to limit blood loss. However, reinjecting clots may cause embolic complications. The primary objective was to assess fibrinogen consumption in the clearing fluid as an indicator of clot formation over time. Additionally, we searched for macroscopic clots, evaluated changes in prothrombin time, factors II and V. In this prospective observational pilot study, we enrolled adult patients in an intensive care unit with a radial artery catheter who required measurements of hemostasis parameters. We used a locally developed closed blood sampling system. Hemostasis parameters were measured in patients' pure blood (reference) and in the clearing fluid, at 2, 3, and 5 min after the complete filling of the reservoir. Thirty patients were included and 120 samples were analyzed. Fibrinogen levels decreased over time: median [interquartile range (IQR)] of 4.3 [IQR:3.1;5.9] as reference level, 3.6 [IQR:2.7;4.7] at 2 min (p < 0.001), 3.4 [IQR:2.1;4.3] at 3 min (p < 0.001) and 3.0 [IQR:1.7;4.1] g/L at 5 min (p < 0.001). No clot was macroscopically detected in any samples. An antiplatelet agent was administered in 11 (37%) patients. Unfractionated heparin anti-Xa activity was higher than 0.10 UI/ml in 17 (57%). Although no macroscopic clots were observed in the clearing fluid, its coagulation factors decreased over the 5 min following reservoir filling, indicating potential initiation of clot formation. Our findings stress the need for further studies assessing the safety of reinjecting clearing fluid as part of patient blood management.© 2024. The Author(s), under exclusive licence to Springer Nature B.V.

      Pubmed     Copy Citation     Plaintext  

      Add institutional full text...

    Notes

     
    Knowledge, pearl, summary or comment to share?
    300 characters remaining
    help        
    You can also include formatting, links, images and footnotes in your notes
    • Simple formatting can be added to notes, such as *italics*, _underline_ or **bold**.
    • Superscript can be denoted by <sup>text</sup> and subscript <sub>text</sub>.
    • Numbered or bulleted lists can be created using either numbered lines 1. 2. 3., hyphens - or asterisks *.
    • Links can be included with: [my link to pubmed](http://pubmed.com)
    • Images can be included with: ![alt text](https://bestmedicaljournal.com/study_graph.jpg "Image Title Text")
    • For footnotes use [^1](This is a footnote.) inline.
    • Or use an inline reference [^1] to refer to a longer footnote elseweher in the document [^1]: This is a long footnote..

    hide…