A flow dynamic technique used to assess global haemostasis

Abstract

Global haemostasis was assessed on blood from patients with established blood clotting abnormalities using a hollow fibre flow device. The instrument monitors pressure changes across a polyethylene fibre through which non-anticoagulated whole blood is perfused. This method of analysis is significant because it (1) minimizes or eliminates common problems associated with routine clinical evaluations, such as sample dilution, completion time, and anticoagulant artifacts, (2) rapidly (under 90 min) and accurately calculates in vitro bleeding time (IVBT) and whole blood clotting time (WBCT), (3) presents a reliable means of distinguishing coagulation defects from platelet dysfunction, and (4) reduces the need for a series of screening tests to a single test that requires a small amount of non-anticoagulated whole blood. Using this technology, global haemostasis of normal volunteers was studied using blood samples spiked with PPACK and prostacyclin. Blood from patients with acquired factor VIII deficiency and Glanzmann's thrombasthenia and from those receiving Coumadin therapy were also studied. The hollow fibre device detailed haemostatic abnormalities of both congenital and therapeutic conditions.