Based at The Prince Charles Hospital in Brisbane, the Haemostasis Research Laboratory has completed five large single-centre studies in the area of cardiopulmonary bypass surgery over the last 10 years. This work has been internationally published and resulted in procedural improvements and increased efficiencies in clinical practice.
The Prince Charles Hospital Foundation, The Prince Charles Hospital Private Practice Research and Education Trust Fund and a number of private companies have funded this work.
Milestones of the Haemostasis Research Laboratory
- First to describe the instrument effect on the International Sensitivity Index (I.S.I.) of a thromboplastin (Thromb Haemostas, 1990; 63: 424-429). Now most commercial thromboplastins supply instrument specific I.S.I. values and most laboratories establish their own ISI values.
- First to describe a serious carry-over artefact on the Instrumentation Laboratory coagulation analyser (ACL) (Aus J Med Lab Sci 1991; 12(4): 124-129). Worldwide, ACLs have since been modified to overcome this artefact.
- First to describe a shortening of the APTT being used to monitor heparin therapy when a low volume sample was drawn (Thromb Haemostas 1991; 66(3): 387-388). This effect is now taken into account in most coagulation laboratories.
- Described the benefits of preoperative platelet function testing to target cardiac surgery patients who will require antifibrinolytic therapy (Ann Thorac Surg 1997; 63:57-63). This protocol is currently in use at TPCH.
- Described the mechanism whereby aprotinin produces benefit during cardiopulmonary bypass (Thromb Haemostas 1997; 78: 1021-60). This is now becoming accepted as the principle mechanism of the process.
- Described a previously unknown mechanism whereby epsilon aminocaproic acid inhibits fibrinolysis during cardiopulmonary bypass surgery (Blood Coagul Fibrinolysis 2001; 12: 129-35).
- Described the variable effecting point-of-care monitoring of anti GPIIb/IIIa therapy during percutaneous coronary intervention (PCI) Catheter Cardiovasc Interv 2004; 62: 150-154.
- Described the effectiveness of aprotinin and epsilon aminocaproic acid in reducing bleeding after total hip replacement (J Thromb Haemostas 2005; 3: 1421-1427).
- Described the risks associated with the practice of reinfusion of drainage blood after total knee replacement (Clinical Orthopaedics & Related Research March 2007 456:238-242).
- Showing the benefits of using low molecular weight heparin rather than unfractionated heparin as anticoagulant during PCI (Submitted JACC 2008).
- Established the stability of the APTT used to monitor unfractionated heparin (J Thromb Haemostas 2008; 6: 1817-1819).
- Compared mechanisms of bivalirudin and unfractionated heparin used during percutaneous coronary intervention (Submitted Eurointervention 2008).