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Table of Contents
VIDEO COMMENTARY  
Year : 2016  |  Volume : 19  |  Issue : 3  |  Page : 530-532
Simulation in thromboelastography: Platelet mapping assay (Part - I)


Department of Cardiac Anaesthesia, Cardio Thoracic Centre, All India Institute of Medical Sciences, New Delhi, India

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Date of Web Publication6-Jul-2016
 

How to cite this article:
Bhardwaj V, Kapoor PM, Hasija S, Singh U. Simulation in thromboelastography: Platelet mapping assay (Part - I). Ann Card Anaesth 2016;19:530-2

How to cite this URL:
Bhardwaj V, Kapoor PM, Hasija S, Singh U. Simulation in thromboelastography: Platelet mapping assay (Part - I). Ann Card Anaesth [serial online] 2016 [cited 2019 Nov 17];19:530-2. Available from: http://www.annals.in/text.asp?2016/19/3/530/185553


Thromboelastography (TEG) platelet mapping assay measures maximal amplitude (MA) of clot firmness, reflecting maximal platelet function. The assay detects the reduction in platelet function, by antiplatelet medications, and presents it as percentage inhibition/aggregation.

Steps of thromboelastography platelet mapping assay

Login and perform e-test


Login to the TEG software by entering the username and password. Perform e-test for the two channels by putting TEG analyzer lever on test mode. Once the e-test is OK, put the lever back on load mode. Enter patient details and activator used in the channel [Figure 1].
Figure 1: Login and perform e-test

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Seat the cup in analyzer

Place cup in analyzer seat and slide the carrier up. Lock the pin with pusher by pressing 2-3 times and slide the carrier down. Seat the cup in analyzer [Figure 2].
Figure 2: Seat the cup in analyzer

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Collect patient blood in thromboelastography kaolin vial and sodium heparin vial

Put patient blood in vial containing kaolin activator up to mark one for basic TEG and in sodium heparin vial for platelet mapping [Figure 3].
Figure 3: Collect patient blood in thromboelastography kaolin vial and sodium heparin vial

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Add 10 μl of calcium chloride and 360 μl blood in a cup with specially designed pipettes [Figure 4].
Figure 4: Add 10 μl of calcium chloride and 360 μl blood in cup with specially designed pipettes

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Start the basic thromboelastography test

Slide the carrier up, put the lever on test mode and start the basic TEG test using only kaolin activator. Note the R, K, MA, lysis thirty values [Figure 5].
Figure 5: Start the basic thromboelastography test

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Start platelet mapping tests by adding distill water in p1, p2, p3 platelet mapping vials

Add 50 μl of distill water in p1 vial containing activator F in powder form. Add 100 μl of distill water in vial p2 and p3 containing adenosine di-phosphate (ADP) and arachidonic acid (AA) [Figure 6].
Figure 6: Start platelet mapping tests by adding distill water in p1, p2, p3 platelet mapping vials

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Seat the cup in second analyzer channer. Add activator F and blood in cup. Start the first platelet mapping test

Add 10 μl of diluted activator (activator F) from p1 vial and 360 μl of blood from sodium heparin vial, in the cup with the pipette. Mix them well [Figure 7].
Figure 7: Seat the cup in second analyzer channer. Add activator F and blood in cup. Start the first platelet mapping test

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Start second platelet mapping assay with adenosine diphosphate activator

Once the MA value of first platelet mapping assay is observed, start the second test by adding 10 μl of activator F (p1 vial), 10 μl of ADP activator (p2 vial), and 360 μl of blood in the cup [Figure 8].
Figure 8: Start second platelet mapping assay with adenosine diphosphate activator

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Start third platelet mapping assay with arachidonic acid activator

Once the MA value of the second platelet mapping assay is observed, start the third test by adding 10 μl of activator F (p1 vial), 10 μl of AA activator (p3 vial), and 360 μl of blood from sodium heparin vial in the cup [Figure 9].
Figure 9: Start third platelet mapping assay with arachidonic acid activator

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Observe the overlapping platelet mapping graphs of basic thromboelastography and platelet mapping for percentage inhibition/aggregation. Note the MA value of each test [Figure 10].
Figure 10: Observe the overlapping platelet mapping graphs of basic thromboelastography and platelet mapping for percentage inhibition/aggregation. Note the MA value of each test

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Part - II

Watch-out for platelet Mapping Analysis in Oct - Dec 2016 issue.

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Correspondence Address:
Vandana Bhardwaj
Senior Resident, Department of Cardiac Anaesthesia, CNC, All India Institute of Medical Sciences, New Delhi
India
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Source of Support: None, Conflict of Interest: None


DOI: 10.4103/0971-9784.185553

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    Figures

  [Figure 1], [Figure 2], [Figure 3], [Figure 4], [Figure 5], [Figure 6], [Figure 7], [Figure 8], [Figure 9], [Figure 10]



 

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