Principles of Dielectric Blood Coagulometry as a Comprehensive Coagulation Test
- Publication date
- 2015
- Publisher
Abstract
Dielectric blood coagulometry (DBCM)
is intended to support hemostasis
management by providing comprehensive information on blood coagulation
from automated, time-dependent measurements of whole blood dielectric
spectra. We discuss the relationship between the series of blood coagulation
reactions, especially the aggregation and deformation of erythrocytes,
and the dielectric response with the help of clot structure electron
microscope observations. Dielectric response to the spontaneous coagulation
after recalcification presented three distinct phases that correspond
to (P1) rouleau formation before the onset of clotting, (P2) erythrocyte
aggregation and reconstitution of aggregates accompanying early fibrin
formation, and (P3) erythrocyte shape transformation and/or structure
changes within aggregates after the stable fibrin network is formed
and platelet contraction occurs. Disappearance of the second phase
was observed upon addition of tissue factor and ellagic acid for activation
of extrinsic and intrinsic pathways, respectively, which is attributable
to accelerated thrombin generation. A series of control experiments
revealed that the amplitude and/or quickness of dielectric response
reflect platelet function, fibrin polymerization, fibrinolysis activity,
and heparin activity. Therefore, DBCM sensitively measures blood coagulation
via erythrocytes aggregation and shape changes and their impact on
the dielectric permittivity, making possible the development of the
battery of assays needed for comprehensive coagulation testing