We use cookies to understand how you use our site and to improve your experience. This includes personalizing content and advertising. To learn more, click here. By continuing to use our site, you accept our use of cookies. Cookie Policy.

Features Partner Sites Information LinkXpress
Sign In
Advertise with Us
PURITAN MEDICAL

Download Mobile App




Tests Used to Measure Internal Bleeding Possibly Unreliable

By LabMedica International staff writers
Posted on 09 Sep 2015
Print article
The point-of-care INRatio PT/INR monitor system
The point-of-care INRatio PT/INR monitor system (Photo courtesy of Abbott Rapid Diagnostics)
Internal bleeding may be uncommon as a result of taking blood thinners, but the normal coagulation tests physicians use to check for the side effect of bleeding may not be reliable.

Oral anticoagulants are administered at fixed daily doses, without the need for laboratory-guided adjustments, but there are limited data available on supratherapeutic doses or overdose of the oral Xa inhibitors and recently the clinical effect in patients exposed to rivaroxaban and apixaban has been characterized.

Scientists at the Nationwide Children’s Hospital (Columbus, OH, USA) and their colleagues carried out a retrospective study and collected data from more than 800 hospitals and eight regional poison centers covering nine USA states. Data were collected on patients who contacted one of the participating poison centers between January 1, 2012, and December 31, 2014. Data were recorded at the occurrence of the case by trained specialists such as nurses, pharmacists, or physicians, during the routine management of the exposure.

Of the 223 patients involved in the study, bleeding was reported in only 15 (7%), and coagulation tests were normal in most patients with bleeding, prothrombin time (PT) 83%, partial thromboplastin time (PTT) 83%, and international normalized ratio (INR) 44%. The PT was shown to be elevated in volunteer studies with rivaroxaban and also elevated in massive overdose. However results of the PT after use of blood thinners varied with different components. The effects of medications on the PTT are short lived and varies based on the reagents used. In patients with bleeding, PT and PTT were elevated in one of four with rivaroxaban and none with apixaban.

In a single case with measured serum rivaroxaban concentration, the PT was recorded as 126.3 seconds. Without specific clarification of methodology and reagent use, the PT and PTT may not reliably predict risk of bleeding after rivaroxaban or apixaban ingestion. The INR was elevated in only 21% of patients tested with rivaroxaban and in no patients with apixaban. In patients with bleeding, the INR was elevated in five of eight with rivaroxaban but in none with apixaban. The use of activated clotting time also appears to be insensitive after the use Xa inhibitors.

Henry Spiller, D.ABAT, a toxicologist and coauthor of the study, said, “One way to overcome the variation in these tests is to use anti-factor Xa chromogenic assays to measure Xa plasma concentrations; however these are not widely available and a potential drawback with measuring anti-factor Xa concentrations and plasma rivaroxaban and apixaban concentrations is that the turnaround time for results may be too long to guide a treatment plan.” The study was published on August 24, 2015, in the Annals of Emergency Medicine.

Related Links:

Nationwide Children’s Hospital 


Platinum Member
COVID-19 Rapid Test
OSOM COVID-19 Antigen Rapid Test
HLX
Anti-Cyclic Citrullinated Peptide Test
GPP-100 Anti-CCP Kit
Gold Member
Xylazine Immunoassay Test
Xylazine ELISA
Read the full article by registering today, it's FREE! It's Free!
Register now for FREE to LabMedica.com and get complete access to news and events that shape the world of Clinical Laboratory Medicine.
  • Free digital version edition of LabMedica International sent by email on regular basis
  • Free print version of LabMedica International magazine (available only outside USA and Canada).
  • Free and unlimited access to back issues of LabMedica International in digital format
  • Free LabMedica International Newsletter sent every week containing the latest news
  • Free breaking news sent via email
  • Free access to Events Calendar
  • Free access to LinkXpress new product services
  • REGISTRATION IS FREE AND EASY!
Click here to Register








Channels

Clinical Chemistry

view channel
Image: Reaching speeds up to 6,000 RPM, this centrifuge forms the basis for a new type of inexpensive, POC biomedical test (Photo courtesy of Duke University)

POC Biomedical Test Spins Water Droplet Using Sound Waves for Cancer Detection

Exosomes, tiny cellular bioparticles carrying a specific set of proteins, lipids, and genetic materials, play a crucial role in cell communication and hold promise for non-invasive diagnostics.... Read more

Molecular Diagnostics

view channel
Image: The study showed the blood-based cancer screening test detects 83% of people with colorectal cancer with specificity of 90% (Photo courtesy of Guardant Health)

Blood Test Shows 83% Accuracy for Detecting Colorectal Cancer

Colorectal cancer is the second biggest cause of cancer deaths among adults in the U.S., with forecasts suggesting 53,010 people might die from it in 2024. While fewer older adults are dying from this... Read more

Microbiology

view channel
Image: The new platform is designed to perform blood-based diagnoses of nontuberculosis mycobacteria (Photo courtesy of 123RF)

New Blood Test Cuts Diagnosis Time for Nontuberculous Mycobacteria Infections from Months to Hours

Breathing in nontuberculous mycobacteria (NTM) is a common experience for many people. These bacteria are present in water systems, soil, and dust all over the world and usually don't cause any problems.... Read more

Industry

view channel
Image: These new assays are being developed for use on the recently introduced DxI 9000 Immunoassay Analyzer (Photo courtesy of Beckman Coulter)

Beckman Coulter and Fujirebio Expand Partnership on Neurodegenerative Disease Diagnostics

Beckman Coulter Diagnostics (Brea, CA, USA) and Fujirebio Diagnostics (Tokyo, Japan) have expanded their partnership focused on the development, manufacturing and clinical adoption of neurodegenerative... Read more
Copyright © 2000-2024 Globetech Media. All rights reserved.