2018 QCM-D sensor for the dose management of Apixaban in replacement surgery

Authors:  Munawar Hussaina, KatrinSchmidtc, Mareike K. Körberc, Elisabeth Langere,f, Oksana Faulb, HinnakNorthoffb, Hans P. Wendela, Christian von Heymannc,d, Frank K.Gehringa

Journal: Sensors and Actuators B: Chemical, Vol. 275, pp 110-115


a Biosensor Research Group, Thoracic, Cardiac and Vascular Surgery Department, Tuebingen University, Germany
b Institute of Clinical and Experimental Transfusion Medicine, Tuebingen University, Germany
c Charité Universitätsmedizin Berlin, Humboldt-Universität zu Berlin and Berlin Institute of Health, Department of Anesthesiology and Operative Intensive Care Medicine (CCM, CVK), Campus Virchow Klinkum, Augustenburger Platz 1, 13353 Berlin, Germany
d Vivantes Klinikum im Friedrichshain, Department of Anesthesiology, Intensive Care Medicine, Emergency Medicine and Pain Medicine, Landsberger Allee 49, 10249 Berlin, Germany
e Labor Berlin—Charite Vivantes, GmbH, Berlin, Germany
f Institute for Laboratory Medicine, Clinical Chemistry and Pathobiochemistry, Charité-Universitätsmedizin Berlin, Campus Charité Virchow Klinikum, Berlin, Germany


Apixaban has been recently permitted for medication and the clinics lack an antidote for overturning the drug's effect. We present the first report of the safe dose management of Apixaban in the risk of bleeding connected with the specific agent in replacement surgery. For this study, an unprecedented technique of ”Quartz Crystal Microbalance with Dissipation” (QCM-D) has been utilized, while the QCM-D-assays of ”activated Partial Thromboplastin Time” (aPTT) and ”Thrombin Time” (TT) have been evaluated in parallel with the standard assays. Here, the acoustic signals are substantial for an evaluation of visco-elasticity of the clot, while the ”clinical standard” does not yield important information related to the anticoagulant. The two equipment have been subjected to 370 samples, including 220 plasma specimens of patients under medication with Apixaban (during knee or hip replacement surgery). In testing, the coagulation times of the QCM-D-assays demonstrated an attractive co-relation with those of the standard assays within analytical limits of deviations. Conclusively, the QCM-D-aPTT is the ”standard assay” for a dosage management of Apixaban, where the (frequency shifts / dissipation shifts) Δf/ΔΓ ratio of the QCM-D-assay reveals that Apixiban with FVII 90 combination could offer a secure medication to control Apixaban-induced bleeding in clinics.