The influence of dead space in blood sampling needle on FVIII level and pharmacokinetic profiles in children with hemophilia.

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  • Additional Information
    • Source:
      Publisher: Taylor & Francis Country of Publication: England NLM ID: 9708388 Publication Model: Print-Electronic Cited Medium: Internet ISSN: 1607-8454 (Electronic) Linking ISSN: 10245332 NLM ISO Abbreviation: Hematology Subsets: MEDLINE
    • Publication Information:
      Publication: 2016- : Abingdon : Taylor & Francis
      Original Publication: [Amsterdam] : Newark, NJ : Harwood Academic Publishers ; International Publishers Distributor,
    • Subject Terms:
      Factor VIII*/pharmacokinetics ; Hemophilia A*/blood ; Hemophilia A*/diagnosis ; Partial Thromboplastin Time*/standards ; Blood Specimen Collection*/standards; Child ; Humans ; Blood Coagulation ; Half-Life ; Needles
    • Abstract:
      Objective: To investigate the influence of the dead space in disposable blood sampling needle on activated partial thromboplastin time (APTT), FVIII level and pharmacokinetic (PK) profiles in children with hemophilia.
      Methods: Children (<18 years) with severe hemophilia A were enrolled. After three days' washout-period, blood samples were collected at pre-dose, 1 h, 3 h, 9 h, 24 h and 48 h post-infusion. At each timepoint, two 2 mL vacuum tubes with 3.2% trisodium citrate were used. The first tube was signed as 'non-standard' (NS) and the second tube was signed as 'standard' (S). FVIII activities were evaluated by one-stage assay. WAPPS-Hemo was used to generate PK profiles like half-life time (t 1/2 ), clearance (CL), trough level and time to 1, 2 and 5IU/dL after a dose of 50 ± 10IU/dL. The FVIII activities at 9 h and 24 h post-infusion were put into WAPPS and thus brought four combinations by true or biased FVIII level that used.
      Result: Compared with standard-collected blood samples, prolonged APTT results ( P -values < 0.01) and decreased FVIII activity ( P -values < 0.05) were revealed in those non-standard blood samples. The corresponding bias was in positive relation to both APTT-S (r = 0.44, P  < 0.0001) and FVIII-S level(r = 0.68, P  < 0.001). The FVIII bias percentage got larger as FVIII-S level reduced (r = -0.24, P  < 0.01). During the four combinations of FVIII activity at 9 h and 24 h, statistically longer t 1/2 , lower CL and longer time to 1, 2 or 5IU/dL were observed in 9H-S&24H-S group and 9H-NS&24H-S group.
      Conclusion: While using vacuum tubes for clotting indicators and PK profiles, the dead space of blood sampling needle should be eliminated in advance.
    • Contributed Indexing:
      Keywords: APTT; blood sampling; children; dead space; factor VIII; half-life time; hemophilia; pharmacokinetics
    • Accession Number:
      9001-27-8 (Factor VIII)
    • Publication Date:
      Date Created: 20240212 Date Completed: 20240220 Latest Revision: 20240220
    • Publication Date:
      20240221
    • Accession Number:
      10.1080/16078454.2024.2314871
    • Accession Number:
      38346146