The Relation Between the Activated Partial Thromboplastin Time Response and Recurrence in Patients With Venous Thrombosis Treated With Continuous Intravenous Heparin

1996 ◽  
Vol 156 (15) ◽  
pp. 1677 ◽  
Author(s):  
Sonia Anand
1993 ◽  
Vol 2 (1) ◽  
pp. 81-87 ◽  
Author(s):  
T Thomason ◽  
B Riegel ◽  
D Jessen ◽  
Smith SCJr ◽  
I Gocka ◽  
...  

OBJECTIVE: To evaluate the clinical safety of heparin titration and the procedural cost of anticoagulation measurement using bedside low-range activated clotting time. DESIGN: Quasi-experimental study using data gathered through retrospective record review. SETTING: Coronary care, medical intensive care and telemetry units of a community hospital. SUBJECTS: Sample of 102 patients undergoing elective percutaneous transluminal coronary angioplasty. INTERVENTION: Intravenous heparin therapy was titrated using low-range activated clotting time in 51 percutaneous transluminal coronary angioplasty patients. Data from this group were compared to a matched sample of 51 angioplasty patients whose intravenous heparin therapy was titrated using activated partial thromboplastin time. RESULTS: No differences in procedural, early or late complications were found between the groups. The cost of managing heparin therapy with low-range activated clotting time was less than with activated partial thromboplastin time. CONCLUSION: These results suggest that titrating heparin therapy based on bedside low-range activated clotting time for the angioplasty patients in this sample was as safe as with activated partial thromboplastin time. Use of bedside low-range activated clotting time saved money for the hospital.


2014 ◽  
Vol 134 (1) ◽  
pp. 165-168 ◽  
Author(s):  
Maheswari Senthil ◽  
Preeti Chaudhary ◽  
David D. Smith ◽  
Patrick E. Ventura ◽  
Paul H. Frankel ◽  
...  

2018 ◽  
Vol 12 (3) ◽  
pp. 146-150
Author(s):  
Enrica Tse ◽  
Rshmi Khurana ◽  
Gwen Clarke ◽  
Winnie Sia

Background Intravenous unfractionated heparin infusion is often used to minimize the duration of time without anticoagulation around delivery in pregnant patients with high thrombotic risk. Activated partial thromboplastin time is commonly used to monitor and adjust heparin dose. However, using activated partial thromboplastin time is problematic in pregnancy because activated partial thromboplastin time response to unfractionated heparin is attenuated due to elevated Factor VIII levels and may lead to incorrect dosing. Case We report a case of deep venous thrombosis occurring in a term pregnancy managed by intravenous unfractionated heparin adjusted using anti-Xa level around the time of delivery. We modified the intravenous unfractionated heparin nomogram by using anti-Xa levels instead of activated partial thromboplastin time and observed lower dosing of unfractionated heparin than otherwise required to achieve and maintain target levels. Conclusion This report demonstrates the feasibility and effectiveness of using anti-Xa level to monitor and adjust intravenous unfractionated heparin infusion in pregnancy.


Angiology ◽  
2009 ◽  
Vol 60 (3) ◽  
pp. 358-361 ◽  
Author(s):  
Alexander D. Douglas ◽  
Jo Jefferis ◽  
Rishi Sharma ◽  
Rachel Parker ◽  
Ashok Handa ◽  
...  

Introduction Patients on intravenous heparin require regular activated partial thromboplastin time monitoring. Laboratory-based activated partial thromboplastin time assays necessitate a delay between blood sampling and dose adjustment. Point-of-care testing could permit immediate dose adjustments, potentially enabling tighter control of anticoagulation. Aim To assess equivalence of activated partial thromboplastin time measured by conventional laboratory assay and by a novel proprietary point-of-care testing system (Hemochron Response, ITC, Thoratec Corporation, Edison, NJ) among surgical ward patients on intravenous heparin. Methods A total of 39 blood samples from patients on intravenous heparin were tested with both laboratory and point-of-care assays. Assay equivalence was assessed by Bland-Altman analysis. Results. Point-of-care measurements exceeded laboratory activated partial thromboplastin time by a mean of 15 seconds (standard deviation 19). In 19 cases (49%), the point-of-care measurement would have resulted in different heparin dosing from the laboratory activated partial thromboplastin time. Conclusions The Hemochron Response system is not sufficiently accurate for routine ward use compared with laboratory activated partial thromboplastin time assays.


1996 ◽  
Vol 3 (3) ◽  
pp. 187-191 ◽  
Author(s):  
Sarah Broder ◽  
Peter Paré

Pulmonary embolism in pregnancy is a significant and under-recognized problem. In British Columbia, where there are 46,000 pregnancies per year, it is estimated that there are approximately 160 pulmonary embolisms per year and one maternal death every two years secondary to pulmonary embolism. A complete assessment for suspected pulmonary embolus can be performed without putting the fetus at significant risk from radiation exposure. An algorithm is provided for the workup of pulmonary embolus during pregnancy. Heparin is the drug of choice for anticoagulating pregnant women, initially managing the situation with intravenous heparin and then switching to the subcutaneous route given in a bid or tid regimen, aiming to keep the activated partial thromboplastin time 1.5 to 2 times the control. The risks to both the fetus and the mother from anticoagulation during pregnancy are reviewed.


Sign in / Sign up

Export Citation Format

Share Document