Maintaining adequate anticoagulation on extracorporeal membrane oxygenation therapy: Hemochron Junior Low Range versus Hemochron 400.
Maintaining adequate anticoagulation on extracorporeal membrane oxygenation therapy: Hemochron Junior Low Range versus Hemochron 400.
复制标题
在体外膜氧合治疗中保持足够的抗凝作用：Hemochron Junior Low Range 与 Hemochron 400。
DOI：
10.1051/ject/200335135
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发表时间：
2003
期刊：
影响因子：
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通讯作者：
MD† R. Lawrence Moss
中科院分区：
文献类型：
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作者：
MD Christopher E. Colby;Nnp Arlene Sheehan;MD William Benitz;MD Krisa Van Meurs;MD Louis P. Halamek;MD† R. Lawrence Moss
体外膜肺氧合（ECMO）治疗要求患者进行抗凝治疗，以防止凝血和血栓并发症。有几种床边全血微凝系统可用于测定活化凝血时间 (ACT) 水平。许多 ECMO 中心使用 Hemochron（新泽西州爱迪生的 International Technidyne）产品来确定 ACT 水平。在研究期间，我们使用了 Hemochron 400，然后更换为 Hemochron Junior Low Range。这项研究有两个具体目标。首先，确定这两种不同的 Hemochron 产品测量的 ACT 水平是否存在差异，这两种产品均用于 ECMO 治疗。其次，确定这两种设备产生的不同 ACT 水平是否会影响临床结果。我们比较了从四名接受肝素的新生儿 ECMO 患者获得的 70 份配对血液样本中两种设备之间的 ACT 水平。对 77 名 ECMO 患者进行回顾性分析，分析使用这两种产品时发生回路紧急情况的频率和 ECMO 回路寿命的长度。在较低的 ACT 范围内，Hemochron Jr. LR 始终产生比 Hemochron 400 更高的 ACT 值。在较高 ACT 范围内，Hemochron Jr. LR 始终产生比 Hemochron 400 更低的 ACT 值。在更换设备后，如果不进行校准，这种差异会导致电路寿命缩短和电路凝血并发症增多。在校准和调整目标 ACT 值后，电路寿命有更长的趋势，并且凝血并发症也更少。 Hemochron 400 和 Hemochron Jr. LR 产生的 ACT 值存在差异。更换机器后未能校准目标 ACT 水平可能会导致电路寿命缩短和更多凝血并发症。
Extracorporeal membrane oxygenation (ECMO) therapy requires that patients be anticoagulated to prevent clotting and thrombotic complications. There are several bedside whole blood microcoagulation systems available to determine activated clotting time (ACT) levels. Many ECMO centers use Hemochron (International Technidyne, Edison, NJ) products to determine ACT levels. During the study period, we used the Hemochron 400 and then changed to the Hemochron Junior Low Range. There were two specific aims of this study. First, to determine if there was a difference in ACT levels measured by these two distinct Hemochron products both marketed for the use in ECMO therapy. Second, to determine if the differing ACT levels produced by these two devices affected clinical outcomes. We compared ACT levels between two devices on 70 paired blood specimens obtained from four neonatal ECMO patients receiving heparin. A retrospective review of 77 ECMO patients was performed to analyze frequency of circuit emergencies and length of ECMO circuit life while using the two products. In lower ACT ranges, the Hemochron Jr. LR consistently yielded higher ACT values than the Hemochron 400. In higher ACT ranges, the Hemochron Jr. LR consistently yielded lower ACT values than the Hemochron 400. Without calibration, after changing devices, this discrepancy led to shorter circuit life and more circuit clotting complications. After calibration and adjustment in target ACT values, there was a trend toward longer circuit life, and there were fewer clotting complications. There is a difference in the ACT values produced by Hemochron 400 and Hemochron Jr. LR. Failure to calibrate target ACT levels after changing machines may lead to shorter circuit life and more clotting complications.