In vitro and ex vivo Measurement of Prophylactic Dabigatran Concentrations with a New Ecarin-Based Thromboelastometry Test

摘要: Background: An increasing number of oral anticoagulants has been approved, including dabigatran etexilate (DE). DE is a direct thrombin inhibitor that requires no routine monitoring, but, if necessary (e.g. urgent surgery etc.), the diluted time measured with Hemoclot® shown reliable results. So far, point-of-care (PoC) assay available to measure effects. The EcaTEM uses ecarin initiate coagulation cascade at step generation and measures clotting (CT) by thromboelastometry. Methods: This study investigated correlation standard laboratory assays in dabigatran-treated patients. Ten patients undergoing total hip or knee arthroplasty were included study. for thromboprophylaxis was started 4 h after surgery. Blood samples taken before as well 2, 6 12 ingestion on 3rd postoperative day. Dabigatran concentration (Hemoclot), activated partial thromboplastin time, CT measured. Results: Only Hemoclot showed > 0.75 all measurements. Conclusion: appears valid PoC method parameter detect inhibition thus presence beside different levels. may represent an opportunity identify dabigatran, e.g., emergency situations.