An ex vivo comparison of partial thromboplastin time and activated clotting time for heparin anticoagulation in an ovine model.
An ex vivo comparison of partial thromboplastin time and activated clotting time for heparin anticoagulation in an ovine model.
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DOI：
10.1111/aor.14094
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发表时间：
2022-03
影响因子：
2.4
通讯作者：
Wu ZJ
中科院分区：
文献类型：
--
作者：
Berk ZBK;Shah A;Sun W;Griffith BP;Wu ZJ
绵羊是机械循环支持 (MAC) 的主要模型，肝素抗凝治疗由于简单且成本高，经常通过活化凝血时间 (ACT) 进行监测。在接受长期肝素治疗的患者中，其他抗凝监测策略，例如活化部分凝血活酶时间（aPTT）已被证明是抗凝充分性的更可靠指标，通常由肝素浓度决定。由于在绵羊身上进行的类似研究很少，我们试图在离体模型中使用全羊血液来研究肝素浓度与 ACT 和 aPTT 之间的相关性。从成年雌性多赛特杂交羊中连续抽取新鲜全血，并将等分试样放入含有肝素盐溶液的试管中，肝素盐溶液的浓度范围为每毫升全血 0 至 7.81 U 肝素。测量每个样本的 ACT 和 aPTT 值。该实验用同一只动物进行了四次。进行简单线性回归以确定相关性，并对长期 MAC 患者中常见的低肝素浓度和高肝素浓度进行亚组分析，例如体外膜肺氧合 (ECMO) 和体外循环。 aPTT 测量值与肝素浓度的关系 R2 = 0.7295。 ACT 测量值与肝素浓度的关系 R2 = 0.4628。 aPTT 测量值与 ACT 测量值的 R2 = 0.2974。 aPTT 与肝素浓度之间的相关性强度在低肝素浓度下增强 (R2 = 0.8392)。 aPTT 与肝素浓度以及抗凝水平的相关性比 ACT 更可靠。在较低的肝素浓度下尤其如此，与 ECMO 患者的肝素浓度范围相似。 aPTT 和 ACT 值之间的相关性较差。应进行进一步的体内研究以证实我们的结果。在人类患者中，替代肝素抗凝监测策略，例如活化部分凝血活酶时间 (aPTT) 已被证明比活化凝血时间 (ACT) 更可靠。我们研究了这在离体绵羊模型中的相关性。 aPTT 测量值与肝素浓度的关系 R2 = 0.7295。 ACT 测量值与肝素浓度的关系 R2 = 0.4628。 aPTT 测量值与 ACT 测量值的 R2 = 0.2974。 aPTT 与肝素浓度之间的相关性强度在低肝素浓度下增强 (R2 = 0.8392)。
Sheep are a primary model of mechanical circulatory support (MAC) with heparin anticoagulation therapy frequently being monitored by activated clotting time (ACT) due to ease and cost. In patients undergoing long-term heparin therapy, other anticoagulation monitoring strategies, such as activated partial thromboplastin time (aPTT) have proven to be more reliable indicators for the adequacy of anticoagulation, frequently determined by heparin concentration. As there is a paucity of similar studies in sheep, we sought to investigate the correlation between heparin concentration and ACT and aPTT using whole sheep blood in an ex vivo model. Fresh whole blood was serially drawn from an adult female Dorset-hybrid sheep and aliquots were placed into tubes containing heparin saline solutions with concentrations ranging from 0 to 7.81 U heparin per mL of whole blood. ACT and aPTT values were measured on each of the samples. The experiment was performed four times with the same animal. A simple linear regression was performed to determine correlation, and subgroup analysis was performed on low versus high heparin concentrations typically seen in human patients on long-term MAC, such as extracorporeal membrane oxygenation (ECMO), versus cardiopulmonary bypass, respectively. aPTT measurements versus the heparin concentration had an R2 = 0.7295. ACT measurements versus the heparin concentration had a R2 = 0.4628. aPTT measurements versus the ACT measurements had a R2 = 0.2974. The strength of the correlation between aPTT and heparin concentration increased at low heparin concentrations (R2 = 0.8392). aPTT had a more reliable correlation to heparin concentration and thus anticoagulation level than ACT. This was particularly true at lower heparin concentrations, similar to ranges seen for patients on ECMO. The correlation between aPTT and ACT values was poor. Further in vivo studies should be performed to confirm our results. Alternative heparin anticoagulation monitoring strategies such as activated partial thromboplastin time (aPTT) have proven to be more reliable than activated clotting time (ACT) in human patients. We investigated how this correlates within an ex vivo sheep model. aPTT measurements versus the heparin concentration had an R2 = 0.7295. ACT measurements versus the heparin concentration had a R2 = 0.4628. aPTT measurements versus the ACT measurements had a R2 = 0.2974. The strength of the correlation between aPTT and heparin concentration increased at low heparin concentrations (R2 = 0.8392).
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影响因子：
38.9
作者：
Waele, JJ;Cauwenberghe, S;Colardyn, F
通讯作者：
Colardyn, F
影响因子：
4.2
作者：
Hohlfelder, Benjamin;Kelly, Daniel;Connors, Jean M.
通讯作者：
Connors, Jean M.
影响因子：
2
作者：
Samuel, S.;Allison, T. A.;Choi, H. A.
通讯作者：
Choi, H. A.
影响因子：
4.2
作者：
Bembea, Melania M.;Schwartz, Jamie M.;Strouse, John J.
通讯作者：
Strouse, John J.
DOI：
10.1002/ccd.1810320112
发表时间：
1994-05-01
期刊：
CATHETERIZATION AND CARDIOVASCULAR DIAGNOSIS
影响因子：
--
作者：
REINER, JS;COYNE, KS;ROSS, AM
通讯作者：
ROSS, AM