Korean J Clin Pathol.  1997 Dec;17(6):1002-1011.

Evaluation of D-Phenylalanyl-L-prolyl-L-arginine Chloromethyl Ketone(PPACK) as an Alternative Anticoagulant to Heparin Salts for Analysis of ionized Calcium, Blood Gas, Electrolytes

• Shin KS
• Han WS
• Son BR
• Lee DH

Abstract

BACKGROUND: Heparin salts induce negative proportional bias according to anticoagulant concentration for analysis of ionized calcium (iCa) However, D-phenylalanyl -L-prolyl- L-arginine chloromethyl ketone (PPACK), a selective thrombin inhibitor, do not bind to ionized calcium. Therefore, we evaluated PPACK as an alternative anticoagulant to lithium heparin (Li-Hep) for analysis of ira, blood gases and electrolytes.
METHODS
The concentration of iCa in whole blood anticoagulated with heparin was compared with that in serum of patients admitted to Chungbuk National University Hospital (n=27). The blood gases, electrolytes and iCa according to each anticoagulant concentration (Ll-Hep or PFACK) were analyzed. The concentrations of anticoagulated whole blood (Li-Hep; 50 kIU/L, PPACK ; 75 mumol/L) were compared with those of nonanticoagulated whole blood for blood gases, electrolytes and iCa (n=17),
RESULTS
The results were as follows; whole blood anticoagulated with Li-Hep demonstrated -0.28+/-0.15 mmol/L (26.6%) bias for ira compared with serum. No bias according to each anticoagulated concentrations were observed in analysis of blood gases, potassium and chloride. Negative proportional bias for iCa and sodium in serum anticoagulated with Li-HeP was observed. In comparison, no bias for ira and sodium was observed with PPACK. No bias was observed in analysis of blood gas or electrolytes with each anticoagulated whole blood except for sodium and chloride that had clinically nonsignificant bias. Whole blood anticoagulated with Li-Hep demonstrated a consistent -0.08+/-0.02 mmol/L (6.3%) bias for ira compared with nonanticoagulated whole blood. In comparison, no bias was observed with PPACK-anticoagulated whole blood for iCa.
CONCLUSIONS
We concluded that PPACK is an ideal anticoagulant without bias for analysis of iCa, blood gases and electrolytes.

MeSH Terms

Arginine
Bias (Epidemiology)
Calcium*
Chungcheongbuk-do
Electrolytes*
Gases
Heparin*
Humans
Lithium
Potassium
Salts*
Sodium
Thrombin
Arginine
Calcium
Electrolytes
Gases
Heparin
Lithium
Potassium
Salts
Sodium
Thrombin