• Anaesth Intensive Care · Nov 2016

    The effect of dabigatran on the kaolin-activated whole blood thromboelastogram.

    • A 'Aho and K Byrne.
    • Anaesthesia Registrar, Department of Anaesthesia, Waikato Hospital, Hamilton, New Zealand.
    • Anaesth Intensive Care. 2016 Nov 1; 44 (6): 729-733.

    AbstractDabigatran 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.

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