Evaluation of High-Speed Centrifugation for Plasma Separation to Reduce Turnaround Time in Coagulation Testing at Surin Hospital

Abstract

Background: Treatment of patients with stroke and acute myocardial infarction requires rapid prothrombin time (PT) and activated partial thromboplastin time (aPTT) results to assess prior to treatment with anticoagulants (rTPA). However, the standard method of centrifuging plasma prior to coagulation test analysis takes at least 15 minutes, resulting in long waiting times and a significant obstacle to patient rescue.
Objective: To evaluate the centrifugation method of plasma separation for coagulation testing with the high-speed centrifuge available in the laboratory with the standard centrifugation method for use in the laboratory to obtain accurate and rapid PT, aPTT test results.
Methods: Study of 86 patient plasma (46 did not received anticoagulant and 40 received anticoagulant) leftover specimen at Surin Hospital between November and December 2024. Compare the differences in platelet count, PT, aPTT, Potassium (K), and Lactate dehydrogenase (LDH) values in plasma centrifuged at 3,000 rpm (1,500 g) for 15 minutes and 8,000 rpm (6,153 g) for 3 minutes.
Results: From the blood samples of 86 patients, 46 samples were not receiving anticoagulants and 40 samples were receiving anticoagulants. The platelet count was less than 10,000 cells per microliter according to the CLSI standard. The values of PT, aPTT, K and LDH were not different between the two groups (p ≥ 0.05).
Conclusion: High-speed centrifugation of plasma at 8,000 rpm for 3 minutes can prepare platelet poor plasma without causing hemolysis and the values of PT, INR and APTT test are not different from the standard method at 3000 rpm for 15 minutes. Therefore, the pre-analysis steps of PT, aPTT test can be reduced by at least 12 minutes. The test results can be reported accurately, quickly and efficiently for treating patients in emergency situations.