The point-of-care monitoring of blood clotting function and plate function by using TEG6s under continuation or cessation of anti-platelets and direct oral anticoagulants

2022 Fiscal Year Final Research Report

• Project/Area Number: 19K09356
• Research Category: Grant-in-Aid for Scientific Research (C)
• Allocation Type: Multi-year Fund
• Section: 一般
• Review Section: Basic Section 55050:Anesthesiology-related
• Research Institution: Sapporo Medical University
• Principal Investigator: Edanaga Mitsutaka 札幌医科大学, 医学部, 准教授 (70616169)
• Project Period (FY): 2019-04-01 – 2023-03-31
• Keywords: 血小板機能 / 質的血液凝固機能 / 抗血小板薬 / DOAC / 中止期間 / 手術前モニタリング

Outline of Final Research Achievements

Using TEG6s which is one of the viscoelastic point-of-care devices, we surveyed platelet function and qualitative blood clotting function for continuation or cessation of anti-platelets or direct oral coagulants (DOAC) at the preoperative state and just after operation. We used the platelet mapping method for the patients (n=42) who medicated anti-platelets, and the global hemostasis method for the patients (n=17) who medicated DOAC. The platelet function and blood clotting function were each measured by using about 300 microliter whole blood. As a results, 13 patients were recognized platelet dysfunction at the preoperative state and 22 patients were platelet dysfunction at just after operation. On the other hand, 8 patients were recognized abnormal blood clotting function at the preoperative state and 8 patients were abnormal blood clotting function at just after operation.

Free Research Field

血液凝固

Academic Significance and Societal Importance of the Research Achievements

抗血小板薬に関して、近年の数々のガイドラインからDAPTの使用が普及していることを考えると、血栓のリスクは軽減されるものの、出血リスクが高くなることが大いに予想される。本研究結果から、一般採血では薬物の残存効果は測定できないため、一律に同じ日程の中止期間を設定するのではなく、手術前の血小板機能モニタリングが必要であると考えられた。DOACに関しては、抗血小板薬とは異なり、本装置にて残存効果を直接的にモニタリングはできない。しかしながら、研究結果を踏まえて質的な血液凝固機能を測定する意義は大きいと考えられた。