Evaluation of the activated clotting time and activated partial thromboplastin time for the monitoring of heparin in adult extracorporeal membrane oxygenation patients
Evaluation of the activated clotting time and activated partial thromboplastin time for the monitoring of heparin in adult extracorporeal membrane oxygenation patients
复制标题
DOI：
10.1177/0267659114524264
复制
发表时间：
2014-09-01
期刊：
影响因子：
1.2
通讯作者：
Masud, F.
中科院分区：
文献类型：
--
作者：
Atallah, S.;Liebl, M.;Masud, F.
简介：从历史上看，活化凝血时间（ACT）一直是体外膜肺氧合（ECMO）患者中肝素作用的首选监测试验。然而，很少有成人研究评价其与肝素剂量或其他监测试验（如活化部分凝血活酶时间（aPTT））的相关性。这项回顾性研究旨在评估肝素剂量和这些监测tests.Methods之间的相关性：患者给予肝素滴在ECMO纳入本研究。主要终点是肝素剂量和ACT或aPTT之间的相关性和成对的ACT和aPTT samples.Results之间的关系：46例患者符合研究纳入标准。观察到肝素剂量和aPTT（Pearson积矩相关系数（r）= 0.43 - 0.54）与ACT（r = 0.11 - 0.14）的相关性更好。在配对样本数据中，ACT值在第二组（aPTT 60 - 75秒）和第三组（aPTT> 75秒）之间没有显著差异。结论：肝素剂量相对于ACT与aPTT相关性更好，因此，可以被认为是成人ECMO患者肝素给药的更有效工具。成对的ACT和aPTT样本数据表明这两种抗凝剂监测试验之间的相关性较差。
Introduction: Historically, the activated clotting time (ACT) has been the preferred monitoring test of the heparin effect in extracorporeal membrane oxygenation (ECMO) patients. However, few adult studies have evaluated its correlation to the heparin dose or other monitoring tests, such as the activated partial thromboplastin time (aPTT). This retrospective study sought to evaluate the correlation between the heparin dose and these monitoring tests.Methods: Patients administered a heparin drip during ECMO were included in this study. The primary endpoints were the correlation between heparin dose and ACT or aPTT and the relationship between paired ACT and aPTT samples.Results: Forty-six patients met the criteria for study inclusion. A better correlation was observed for heparin dose and aPTT (Pearson product-moment correlation coefficient (r) = 0.43 - 0.54) versus ACT (r = 0.11 - 0.14). Among the paired sample data, ACT values did not differ significantly between Groups two (aPTT 60 75 seconds) and three (aPTT >75 seconds).Conclusion: The heparin dose correlated better with aPTT relative to ACT and, thus, may be considered a more effective tool for the dosing of heparin in adult ECMO patients. Paired ACT and aPTT sample data suggested a poor relationship between these two anticoagulant monitoring tests.