Diagnostic Value of D-Dimer and INR in Patients Suspected to Have Prosthetic Valve Dysfunction

ABSTRACT Introduction: Prosthetic valve dysfunction is a potentially critical complication of heart valve replacement. An easy and quickly applicable diagnostic procedure is required for recognizing the prosthetic valve dysfunction. The purpose of this study was to prospectively define the diagnostic value of D-dimer and INR level in predicting prosthetic valve dysfunction. Methods: This cross-sectional study was performed in 70 patients suspected to have prosthetic valve dysfunction admitted to Imam Ali Hospital, affiliated with Kermanshah University of Medical Sciences (KUMS), Kermanshah Province, Iran. Cinefluoroscopy, as the gold standard diagnostic test, was used for the diagnosis of prosthetic valve dysfunction in enrolled patients. Two milliliters of blood from each patient were taken into a tube containing sodium citrate anticoagulant. To evaluate D-dimer, the cutoff value was set at 500 ng/ml. Also, to evaluate international normalized ratio (INR), the cutoff value was set at 2. Sensitivity, specificity, positive predictive value (PPV), negative predictive value (NPV), positive likelihood ratio (PLR), and negative likelihood ratio (NLR) of the serum markers were used to describe predictive properties. Results: Of 70 patients, 27 (38.6%) were male and 43 (61.4%) were female, and the mean age was 54.67±15.11 years (range, 18 to 80 years). Of 70 patients, 27 (38.6%) had prosthetic heart valve malfunction demonstrable by fluoroscopy, and 19 patients (27.1%) had D-dimer levels >500 ng/ml. Elevated D-dimer levels (>500 ng/ml) have been indicated to have sensitivity of 70.4%, and hence an NPV of 84.3%, specificity of 100%, PPV of 100%, NLR of 0.3, and the infinity value of PLR for predicting prosthetic valve dysfunction. There was a significant relationship between fluoroscopy and D-dimer test (P=0.001). A kappa coefficient value of 0.745 indicated a substantial agreement between D-dimer and fluoroscopy testing. Mixing test (combination of D-dimer and INR) showed to have 100% sensitivity, and hence a NPV of 69.8%, specificity of 69.8%, PPV of 51.8%, NLR of 1.41, and PLR of 1.44 for predicting prosthetic valve dysfunction. Conclusion: D-dimer with moderate sensitivity and high specificity is an ideal marker for the diagnosis of prosthetic valve dysfunction in suspected patients. Enhanced plasma D-dimer level is not by itself diagnostic of a prosthetic valve dysfunction but may alert physicians to refer the patient for more detailed examination, preferably by fluoroscopy. Mixing test with 100% sensitivity can apply as a rule-out test.

Efectividad de anticoagulación regional con citrato en terapia de reemplazo renal continua / Effectiveness of regional citrate anticoagulation in continuous renal replacement therapy

BACKGROUND: Anticoagulation in continuous renal replacement therapy (CRRT) is essential to counteract the coagulation cascade activation, induced by the dialysis circuit. Heparin is the most widely used anticoagulant, followed by regional citrate anticoagulation (RCA). AIM: To determine the effectiveness and safety of anticoagulant treatment with citrate in CRRT. Material and Methods: Retrospective study of adults in CRRT hospitalized between the years 2014 and 2020 in critical units, who required change to RCA according to established protocols. RESULTS: We studied 24 patients aged 63 ± 13 years (12 females). The reasons for admission were acute kidney injury (AKI) in 80% and stage 5 chronic kidney disease in 20%. The indication of RCA in 75% of patients was by coagulation of more than 3 circuits in 24 hours. The duration of the circuit in RCA was 18.5 ± 4.8 hours versus 11.9 ± 4.9 hours with heparin (p < 0.0001). There were 19 mild complications that did not affect the RCA. Conclusions: RCA is feasible to perform, it is a safe and efficient procedure if it is protocolized, allowing a longer duration of the dialysis circuit.

Effects of low molecular weight heparin sodium and sodium citrate on hemodialysis patients at high risk of bleeding: a comparative study / 中国输血杂志

【Objective】 To compare the therapeutic effects of low molecular weight heparin sodium and sodium citrate on hemodialysis(HD) patients at high risk of bleeding. 【Method】 A total of 96 patients at high risk of bleeding on maintenance hemodialysis from May 2018 to May 2020 were enrolled and divided randomly into control group(n=48) and observation group(n=48). Patients in control group received systemic anticoagulation with heparin, and patients in observation group adopted regional citrate anticoagulation of in vitro dialyzer. The indexes of prothrombin time (PT), activated partial thromboplastin time (APTT), fibrinogen (Fg), D-dimer, service time of filters and the dialysis efficiency, as well as the complication occurrences of clotting events, bleeding, metabolic alkalosis and hypocalcaemia were compared between the two groups. 【Results】 No significant difference was found in coagulation indicators (ACT, PT, Fg, APPT and D-dimer) before and after hemodialysis in observation group(P>0.05), but those in control group were prolonged significantly (P0.05). The incidence of filter clotting (0.0%), dialyzer pipeline clotting (0.0%) and bleeding (2.1%) in observation group were less than those in control group (8.3%, 6.2%, 14.6%, respectively) (P0.05). 【Conclusion】 Regional anticoagulation with citric acid in vitro is safe for patients on maintenance hemodialysis at high risk of bleeding, and can greatly prolong service time of filters, reduce bleeding and thrombocytopenia rates, bring less effects to coagulation function in vivo.

Formulation and sterilization assessment of kanamycin sulfate injection based on impurity profiles / 药学学报

The compatibility of kanamycin with sodium citrate for the formulation of kanamycin sulfate injection was determined, including optimization of the amount of sodium citrate in the injection and the sterilization process. An HPLC coupled with an evaporative light scattering detector (ELSD) was used to measure the amount of sodium citrate and the impurity profiles. A validated post-column derivatization HPLC coupled with a fluorescence detector (FLD) was used to determine the correlation between specific impurities in a domestic factory and sodium citrate, and then the formulation was evaluated by HPLC coupled with mass detector (MS) characterization of degradation products. The results show that the amount of sodium citrate in kanamycin sulfate injection from a domestic factory is about 40 times higher than that of the Meiji formulation. Several specific impurities can be detected in solutions heated under simulated sterilization conditions (121 ℃), which were correlated with the amount of sodium citrate. Impurities were characterized by HPLC-MS/MS, and data showed that the identified impurities were interaction products of kanamycin and sodium citrate. These results indicate that greater attention should be directed at formula optimization in domestic factories, as it is crucial to the safety and efficacy of the preparations. Drug-excipient chemical compatibility should also be evaluated in the development of pharmaceutical dosages forms especially when the active pharmaceutical ingredients have a primary amine group.

Can Sodium Citrate Effectively Improve Olfactory Function in Non-Conductive Olfactory Dysfunction? / 대한이비인후과학회지

The objective of this study was to perform a systematic review of the literature for application of intranasal sodium citrate in the patients with olfactory dysfunction to help determine the sodium citrate treatments for this condition. Two authors independently searched the data base (Medline, Scopus, and the Cochrane database) for relevant studies from inception to January 2018. Included studies were randomized controlled studies published in English comparing topical sodium citrate application (treatment group) with saline (control group) in patients who had olfactory dysfunction. Outcomes of interest included the change of olfactory identification and threshold during 2 hours post-treatment. Three studies were enrolled in the meta-analysis. Compared with control group, treatment group did not increase posttreatment score of olfactory identification [standardized mean difference (SMD)=-0.03; 95% confidence interval (CI)=-0.29-0.24; I²=0%] and olfactory threshold (SMD=0.18; 95% CI=-0.09-0.45; I²=0%) significantly. In the degree of pre-post improvement of two outcomes, although treatment group statistically showed the significant improvement in olfactory threshold (SMD=0.30; 95% CI=0.05-0.55; I²=17%), the clinical significance of this outcome was meaningless. Similarly, there was no significant difference in olfactory identification between two groups (SMD=0.17; 95% CI=-0.11-0.45; I²=22%). Unlike the recent favorable results, our summated results presented the uselessness for the local application of sodium citrate in improving patient's olfactory function. However, we also had some limitation such as small sample size and inconsistent application methods. Therefore, larger trials and standardized methodology are needed to reach more stronger and exact results.

Safety and efficacy of regional citrate anticoagulation in continuous blood purification treatment of patients with multiple organ dysfunction syndrome

The aim of this study was to discuss the safety and efficacy of regional citrate anticoagulation (RCA) on continuous blood purification (CBP) during the treatment of multiple organ dysfunction syndrome (MODS). Thirty-five patients with MODS were divided into two groups: the local citrate anticoagulation (RCA) group, and the heparin-free blood purification (hfBP) group. The MODS severity was assessed according to Marshall's MODS score criteria. Blood coagulation indicators, blood pressure, filter lifespan, filter replacement frequency, anticoagulation indicators, and main metabolic and electrolyte indicators were analyzed and compared between RCA and hfBP groups. RCA resulted in lower blood pressure than hfBP. The filter efficacy in RCA treatment was longer than in the hfBP group. The blood clearance of creatine, blood urea nitrogen and uric acid was better in the RCA group. RCA also led to higher pH than hfBP. Neither treatment resulted in severe bleeding events. In addition, MODS score was positively correlated with prothrombin time and activated partial thromboplastin time but negatively correlated with platelet concentration. RCA is a safer and more effective method in CBP treatment; however, it could also lead to low blood pressure and blood alkalosis.

Sodium citrate anticoagulation in continuous plasma adsorption treatment of clinical research / 中华急诊医学杂志

Objective Explore the sodium citrate anticoagulation in the continuity of plasma adsorption closed-circuit circulation of anticoagulation therapy method and effect. Methods Line into the continuity of plasma adsorption treatment of 156 cases of acute drug poisoning patients were randomly(random number) divided into two groups, 78 cases in each group, respectively adopt low molecular heparin (group A), sodium citrate anticoagulation (group B). Contrast analysis of two groups after the therapy began 30 min, 3 h, 6 h before the filter in patients with pressure, transmembrane pressure, pressure drop, at the same time to compare two groups of 10 min before the start of treatment, after treatment began to 3 h, 6 h platelet, coagulation time live enzymes, vein in the body of free Ca2+, Na+and HCO3- 24 h and internal bleeding. Results Two groups in gender, age, clinical diagnosis, blood purification time comparative differences had no statistical significance (P>0.05);Two groups of 30 min after the start of treatment, 3 h, 6 h patients before pressure, transmembrane pressure, filter pressure drop compared differences were no statistical significance (P>0.05); Part of coagulation treatment after low molecular heparin group live enzymes the sodium citrate group significantly prolonged (P<0.01);Platelets, HCO3- the two groups after treatment, intravenous free Ca2+ and Na+ differences had no statistical significance (P>0.05). Conclusions In the continuous plasma adsorption treatment process using sodium citrate anticoagulation with clinical feasibility, safety.

Determination of Citrate ion Content and Analysis of Related Factors of Aluminum Content in Human Albumin Products / 中国药学杂志

OBJECTIVE: To determine the citrate ion and aluminum contents in human albumin products and investigate the related factors of aluminum content. METHODS: Sixty-five batches of human albumin products which were very close to the end of shelf life or would be expired within not more than 2 m, including 54 batches of imported ones and 11 batches of domestic ones, were analyzed. The content of citrate ion was determined using the enzyme reaction method, and aluminum content was determined using the atomic absorption method. Factors related to human albumin production, such as ultrafiltration time, glass bottles, sample storage conditions, and the initial value of aluminum content were investigated and analyzed, especially the relationship with the aluminum content at the end of the shelf life. RESULTS: The overall mean content of citrate ion in 65 batches of human albumin was 24 μmol•L-1 (0 - 144 μmol• L-1), the mean content of citrate ion in 54 batches of domestic human albumin was 24 μmol•L-1, and that in 11 batches of imported human albumin was 23 μmol•L-1. The linear correlation coefficients between final aluminum content and citrate ion content of 65 batches of human albumin, 54 batches of domestic human albumin and 11 imported human albumin were 0.315 5, 0.331 8 and 0.746 6, respectively. The linear correlation coefficients between the final aluminum content and storage time of 65 batches of human albumin, 54 batches of domestic human albumin and 11 imported human albumin were 0.102 6, 0.059 3 and - 0.037 4, respectively. The linear correlation coefficient between the final and initial aluminum contents of 54 batches of domestic human albumin was 0.325 5. The linear correlation coefficients between final aluminum content and ultrafiltration process time, citrate ions and ultrafiltration process time of 54 batches of domestic human albumin were 0.011 8 and - 0.108 2, respectively. CONCLUSION: Citrate ion content in human albumin retention samples are lower than 150 μmol•L-1. Citrate ion content and final aluminum content are weakly correlated, however, the correlation coefficient between the two indexes of imported human albumin is much higher than that of domestic samples. The initial and final aluminum contents shows low correlation, and ultrafiltration time shows very weak correlation with storage time.

Inactivation of Listeria monocytogenes ATCC 7644 on fresh-cut tomato using nisin in combinations with organic salts

ABSTRACT The inhibition of Listeria monocytogenes ATCC 7644 on fresh-cut tomato was investigated using nisin alone, and in combinations with organic salts. Nisin at a concentration of 5000 UI/mL was introduced alone or in combination with an organic salt (sodium citrate or sodium acetate each at 3 and 5 g/100 mL each) on fresh-cut tomato previously inoculated with 108 CFU/mL of L. monocytogenes ATCC 7644. Chlorine at 200 ppm was used as a control. The inoculated samples were incubated at different temperatures (4, 10 and 25 °C) and examined at 0, 24, 48 and 72 h. The effects of the antimicrobial treatments on quality parameters of tomato (pH, soluble solids, titratable acidity and vitamin C) were also evaluated, and colour parameters were observed at the lowest storage temperature for 10 days. Both nisin and the organic salts inhibited growth of L. monocytogenes, but the combinations of two compounds were more effective. The nisin-sodium citrate (5%) combination was significantly (p ≤ 0.05) effective, while chlorine was least effective against L. monocytogenes. The quality parameters were substantially retained, especially at 4 °C, suggesting good shelf stability at a low temperature. These results substantiate the use of the cheap and eco-friendly approach to reducing this pathogen of health concern in common fresh produce.

Solubilization of Poorly Water Soluble Drug Using Mixed Solvency Approach for Aqueous Injection.

Aim: 1) To increase water solubility of indomethacin drug using mixed solvency approach. 2) To employ use of non toxic solubilizers for increasing solubility of a poorly water soluble drug. Study Design: Trial and error based experimental study. Place and Duration of Study: School of Pharmacy, Devi Ahilya Vishwavidyalaya, UTD, Takshashila Campus, Indore, India and College of Pharmacy, IPS Academy, Indore, India between Jan. 2011 and June. 2012. Methodology: By making mixed solvent (40%) blends of selected water soluble substances from the hydrotropes (urea, sodium benzoate, sodium citrate, nicotinamide); water-soluble solids (PEG- 4000, PEG-6000); and co-solvents (propylene glycol, glycerine, PEG-200, PEG-400, PEG 600) solubility studies were performed with indomethacin (model drug). On the basis of solubility studies formulation was developed. The solubilized drug and prepared formulation were characterized by ultraviolet and infrared techniques. Various properties of solution such as pH, viscosity, specific gravity and surface tension were studied. The developed formulation was studied for physical and chemical stability. Result: Aqueous solubility of drug in case of selected blends ranged from 14.55 mg/ml – 19.96 mg/ml (as compared to the solubility in distilled water 0.0464 ± 0.007 mg/ml). The enhancement in the solubility of drug in a mixed solvent containing 10% sodium benzoate, 5% sodium citrate and 25 % S cosolvent (25% S cosolvent contains PEG200, PEG 400, PEG600, Glycerine and Propylene glycol) was more than 400 fold. Prepared formulation F10 show appreciable physical and chemical stability. Conclusion: The results of this study provide guidance for developing an injectable product and strategies for improving solubility as well as stability of poorly water soluble drug using the concept of mixed solvency. The proposed technique is economical, convenient and safe. The application of mixed solvency approach in the development of formulations shall prove a boon for pharmaceutical industries.

Effect of Sodium Citrate on Growth of Bacteria in Blood Culture / 대한임상미생물학회지

BACKGROUND: This study compared the growth of Staphylococcus aureus, Escherichia coli, Pseudomonas aeruginosa, Streptococcus pneumoniae, and Haemophilus influenzae in blood culture bottles containing anticoagulants, sodium polyanethol sulfonate (SPS) and sodium citrate. METHODS: One hundred and fifty colony forming units of five different bacterial species were inoculated into standard aerobic (SA) and standard anaerobic (SN) bottles and were combined with 5 mL of human blood in solution with SPS or sodium citrate. Time to detection (TTD) was then monitored using the BacT/Alert 3D system (bioMerieux Inc.). RESULTS: Compared to the bacteria-only controls, cultures containing S. aureus, E. coli, P. aeruginosa, and S. pneumoniae plus SPS blood or citrated blood trended toward reduced TTD in both SA and SN bottles; however, there was no significant difference in TTD between SPS and sodium citrate anticoagulant. Although H. influenzae showed a remarkable difference in TTD between SPS (SA 14.8 h, SN 15.0 h) and sodium citrate (SA 23.5 h, SN 18.3 h), this difference was not statistically significant (P=0.10). CONCLUSION: Addition of blood enhanced growth of bacteria. All experimental bacteria except H. influenzae showed similar TTD in SPS blood and citrated blood. These results support the usefulness of sodium citrate anticoagulant for artificial inoculation in blood culture bottles.

Influence of sodium citrate concentration in TISAB on detection of water fluoride / 中国地方病学杂志

Objective To observe the influence of sodium citrate concentrations in TISAB on detection of water fluoride,and to explore the feasibility of 0.10 mol/L sodium citrate buffer system in detection of water fluoride.Methods Under pH 5.0 to 5.5,a series of fluoride standards of 0.2,0.5,1.0,2.0 and 5.0 mg/L were measured when sodium citrate concentration was 0.01,0.10,and 1.00 mol/L in the TISAB system.The results of water fluoride measurement were compared,recovery calculated and regression equation of the standard curve was set up.The feasibility of 0.10 mol/L sodium citrate in the TISAB system to detect water fluoride was tested,including interference test,accuracy,confidence limits,as well as precision test.Water fluoride was determined by fluoride ion selective electrode according to the Standard Test Methods for Drinking Water (GB/T 5750.5-2006).Results When the sodium citrate concentrations in the TISAB system were 0.01,0.10 and 1.00 mol/L,and the concentrations of fluoride in the sample were 0.2,0.5,1.0,2.0 and 5.0 mg/L,recoveries of water fluoride were 96.0％,103.0％,179.5％; 80.6％,97.8％,132.2％; 73.3％,97.0％,103.0％; 70.0％,100.0％,87.5％; and 66.4％,102.0％,65.4％.The equation of linear regression was y =lg-1(226.4-E/47.4),y =lg-1(226.4-E/53.4) and y =lg-1(208.1-E/36.9) ; the correlation coefficient(r) were 0.9993,0.9999 and 0.9993.The minimum detectable concentration and limit of quantitation was 0.023 and 0.072 mg/L when sodium citrate was 0.10 mol/L in the TISAB system.Aluminum(Al3+,100 μg),ferrum(Fe3+,800 μg),calcium(Ca2+,1200 μg),Al3+(50 μg) + Fe3+ (800 μg),Al3+(50 μg) + Ca2+(1200 μg) can be masked when sodium citrate was 0.10 mol/L in the TISAB system.The total average recoveries confidence limit R/d was 0.99.The total standard deviation of standard solution,water sample and spiked water sample was less than 5％ of their respective mean concentration.Conclusions High concentration of sodium citrate buffer system has a significant influence on the detection sensitivity and limit of quantification of fluoride ion in water.The capacity of anti-interference of 0.10 mol/L sodium citrate in the TISAB is strong.The confidence limits of precision and accuracy meet the requirements for fluoride determination in a variety of source water and drinking water.

Prediction of the Shelf Life of Compound Sodium Citrate Injection by Initial Average Rate Stability Test / 中国药房

OBJECTIVE:To predict the shelf life of compound sodium citrate injection by initial average rate stability test. METHODS: The initial average rate stability test was performed at 7 different temperatures to investigate the relationship between the initial average rate (V0) of the glucose degradation reaction and Kelvin's temperature (1/T), and the activation energy of reaction, the drug reaction velocity constant and shelf life were computed as well. RESULTS: The regression equation was lgV0=18.15—6 774.6?1/T(r=—0.937 5), the reaction activation energy was 31.0Kcal?mol-1, the drug reaction velocity constant at 20℃ was 1.1?10-5h-1, and the shelf life was 1.09 years. CONCLUSION: The method is simple and it can accurately predicate the shelf life of compound sodium citrate injection.

Caracterização clínica dos pacientes com hipercalciúria na nefrolitíase / Clinical characterization of patients with hypercalciuria in nephrolithiasis

Introdução: A hipercalciúria é comumente associada à nefrolitíase. Porém, o risco relacionado à formação de cálculos renais é pouco conhecido. Objetivo: Comparar a demografia e a evolução clínica de pacientes com nefrolitíase e hipercalciúria (HC) com pacientes portadores de outros distúrbios metabólicos(NH). Métodos: Foram estudados 155 pacientes com apenas um distúrbio metabólico e que apresentaram seguimento mínimo de um ano. Foram dosados em duas amostras de urina de 24 horas: cálcio, creatinina, sódio, ácido úrico, citrato, oxalato. A avaliação radiológica foi feita com ultra-sonografia e/ou Rxde abdome. Resultados: 69 (44,5%) pacientes apresentaram HC (333±118 mg/dia) e 86 (55,5%) outros distúrbios (NH). Não houve diferenças entre osgrupos na média de idade (40,1 ± 10,8 nos HC vs. 43 ± 13,9 anos NH), proporção homem/mulher, peso e índice de massa corporal (26,14 ± 4,58 HC vs.25,58 ± 5,16 NH). A pressão arterial foi semelhante nos dois grupos. História familiar de cálculo foi maior no grupo NH (44 NH vs. 25 no grupo HC, p<0,019). Os pacientes com HC relataram mais crises álgicas (326 HC vs. 282 NH, p<0,043) e apresentaram proporção maior de cálculos com diâmetro superior a 10 mm. A excreção de sódio foi maior no grupo HC (228,7±79 vs. 158,5±70,1 NH, p<0,0002). Conclusão: A HC esteve presente em 44,5% dos pacientes.Associou-se com maior número de crises álgicas e com cálculos maiores que os do grupo NH. A excreção de sódio foi maior no grupo HC e correlacionousecom a calciúria.

Introduction: Hypercalciuria is a common metabolic disorder associated with nephrolithiasis. However, little is known about the risk related to stoneformation. Objective: To compare demographic data and clinical course of nephrolithiasis patients with hypercalciuria (HC) and patients with others metabolic disorders (NH). Methods: We studied 155 patients with only one metabolic abnormality and with a minimum follow-up of one year. Two 24-h urine collections for volume, pH, calcium, creatinine, sodium, uric acid, citrate, and oxalate were obtained. Radiological evaluation consisted in abdominal ultrasound and/or. X-Ray. Results: Sixty-nine (44.5%) patients presented with HC (333±118 mg/day) and 86 (55.5%) with other metabolic disorders. There were no differences in age (40.1±10.8 HC vs. 43±13.9 years NH), gender, weight, and body mass index (26.14 ± 4.58 HC vs. 25.58 ± 5.16 NH). Blood pressure was similar in both groups. A familial history was present in 44 patients with NH vs. 25 in the HC group (p<0.019). HC patients reported higher frequency of both pain crisis (326 HC vs. 282 NH, p<0.043) and stones larger than 10 mm. Sodium excretion was higher in HC group (228.7±79 vs. 158.5±70.1 NH, p<0.0002). Conclusion: HC was present in 44.5% of patients. It was associated with a higher frequency of both pain crisis and larger stones than NH group. Sodium excretion was higher in HC patients and was directly correlated with urinary calcium.

The comparing research of anticoagulation with sodium citrate or heparin in continuous venovenous hemodiafil- tration / 中国实用内科杂志

Objective To investigate the anticoagultive effectiveness and specialty of sodium citrate comparing with hep- arin in continuous venovenous hemodiafiltration (CVVHDF).Methods 50 multiple organ disorder patients undergoing CWHDF were randomly divided into two groups:group A(sodium citrate)27 cases,group B(heparin)23 cases,blood e- lectrolyte,acid-alkali degree,cruor index changes,the blood coagulation of tube path way and blood filter were recor- ded.As the same time,side effects were observed in theraphy.Results The patients of two groups were kept stable vital signs,serum electrolyte and blood gas markers during the therapeutic periods.Moreover,ideal serum creatinine and urea clearance rate and uhrafiltration rate were obtained in all patients.The coagulation and longevity of blood filter of Group A are better than Group B,Group A without sigaificantly prolonged cruor index inside body,the dosage of calcium gluco- nate in Group A are greater than Group B.Conclusion Out body anticongulation of sodium citrate is more effective and reliable than regular heparin anticoagulation.

A Correlation of Prothrombin Time in Citrated Specimens and EDTA Specimens Examined by Owren Method / 대한진단검사의학회지

BACKGROUND: Sodium citrate has been used as a coagulation test because factor V and VIII are more stable in a citrated specimen. Ethylenediaminetetraacetic acid (EDTA) has been used for the hematologic test because blood cells are preserved better in the EDTA specimen. Both sodium cit-rate and EDTA have the same principle of anticoagulation. They bind free plasma calcium to pre-vent clotting. This study was performed to see if we could substitute EDTA for sodium citrate in pro-thrombin time. METHODS: Blood samples from 133 patients who underwent the prothrombin time test in our hos-pital and 36 healthy controls were used. Each sample was anticoagulated with both sodium citrate and EDTA. We examined the prothrombin time with citrated specimen and EDTA specimen using the Owren reagent; Nycotest PT and also the Quick reagent; and the IL Test PT-Fibrinogen HS. RESULTS: The mean prothrombin time with EDTA specimen was longer than that with the citrated specimen by the Quick method but was shorter using the Owren method. In the Owren method, there was a significant correlation between mean prothrombin time with the citrated and EDTA spec-imen but not using the Quick method. CONCLUSIONS: The prothrombin time with the citrated and EDTA specimens correlated with each other by the Owren method. This correlation could make it possible to replace sodium citrate with EDTA.

Factors influencing the assay of ?_1-antitrypsin bioactivity / 中国输血杂志

Objective To study the factors influencing the assay of ? 1 antitrypsin(? 1 AT) bioactivity. Methods Various concentrations of PEG(MW, 4000), sucrose, sodium citrate and ethanol were added before determining ? 1 AT activity. Results ? 1 AT activity increased approximately 100% compared with the controls when the PEG concentration reached 20%. Conclusion PEG concentration influences the ? 1 AT activity assay.