Accuracy of drawing coagulation samples from heparinized arterial lines

1993 ◽  
Vol 2 (1) ◽  
pp. 88-95 ◽  
Author(s):  
K Templin ◽  
M Shively ◽  
J Riley
Keyword(s):  
Prothrombin Time ◽  
Partial Thromboplastin Time ◽  
Coronary Angioplasty ◽  
Percutaneous Transluminal Coronary Angioplasty ◽  
Activated Partial Thromboplastin Time ◽  
Arterial Line ◽  
Blood Samples ◽  
Transluminal Coronary Angioplasty ◽  
Percutaneous Transluminal ◽  
Line Sample

OBJECTIVE: To determine the accuracy of activated partial thromboplastin time and prothrombin time studies when samples are drawn through heparinized arterial lines. METHODS: A total sample of 90 grouped blood samples (from 30 subjects) was used. Patients were all male, with a mean age of 65 and were studied within 24 hours of percutaneous transluminal coronary angioplasty. Each patient had three venous control and arterial line sample sets (a total of 90 blood samples) drawn when routinely ordered for monitoring therapy. For the arterial line sample, a discard volume of the deadspace, deadspace + 2 mL, or deadspace + 4 mL was randomly assigned for each sample. The venous control volumes were the same for all three sample sets. RESULTS: A 2 x 3 repeated measures analysis of variance was used to analyze the results. The independent variables were the source of the sample (venous vs arterial) and the discard volume of arterial blood (deadspace, deadspace + 2 mL, deadspace + 4 mL). The dependent variables were the activated partial thromboplastin time and prothrombin time values. Mean arterial activated partial thromboplastin time values were significantly higher than the corresponding venous values. Mean activated partial thromboplastin time values were not significantly different among the discard volumes of blood drawn. However, there was a significant source by volume interaction. Tukey post-hoc comparisons of venous-arterial activated partial thromboplastin time differences among the three volumes showed significant differences between deadspace volume and deadspace + 2 mL, and deadspace volume and deadspace + 4 mL. There was no significant difference between deadspace + 2 mL and deadspace + 4 mL volumes. CONCLUSION: Results indicated that the minimal amount of discard volume for accurate activated partial thromboplastin time values in this population of percutaneous transluminal coronary angioplasty patients was the catheter deadspace volume plus 2 mL (total 3.6 mL).

Clinical safety and cost of heparin titration using bedside activated clotting time

1993 ◽  
Vol 2 (1) ◽  
pp. 81-87 ◽  
Author(s):  
T Thomason ◽  
B Riegel ◽  
D Jessen ◽  
Smith SCJr ◽  
I Gocka ◽  
...  
Keyword(s):  
Partial Thromboplastin Time ◽  
Percutaneous Transluminal Coronary Angioplasty ◽  
Heparin Therapy ◽  
Activated Partial Thromboplastin Time ◽  
Clotting Time ◽  
Clinical Safety ◽  
Activated Clotting Time ◽  
Intravenous Heparin ◽  
Transluminal Coronary Angioplasty ◽  
Percutaneous Transluminal

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.

Comparison of PT and aPTT values drawn by venipuncture and arterial line using three discard volumes

1992 ◽  
Vol 1 (3) ◽  
pp. 94-101 ◽  
Author(s):  
E Konopad ◽  
M Grace ◽  
R Johnston ◽  
T Noseworthy ◽  
A Shustack
Keyword(s):  
Prothrombin Time ◽  
Critically Ill ◽  
Partial Thromboplastin Time ◽  
Laboratory Tests ◽  
Activated Partial Thromboplastin Time ◽  
Arterial Line ◽  
Bonferroni Correction ◽  
Blood Samples ◽  
Volume Group ◽  
Paired T Test

BACKGROUND: Blood samples obtained through heparinized arterial catheters are used routinely for a variety of laboratory tests. Accuracy of coagulation studies performed from samples obtained in this fashion continues to be questioned, particularly in regard to the minimum discard volume necessary to clear the catheter of heparinized solution. OBJECTIVE: To examine differences between prothrombin time and activated partial thromboplastin time values obtained from blood drawn by venipuncture and from an indwelling intra-arterial line using three discard volumes. METHODS: Prothrombin time and activated partial thromboplastin time samples were drawn by venipuncture from 41 critically ill adult patients. Simultaneously, three consecutive blood samples of 2.3 mL were drawn from the arterial line after an initial discard volume of 3 mL (discard volumes of 3.0, 5.3 and 7.6 mL). RESULTS: Significant differences were found between arterial and venous prothrombin time values for the 3-mL discard volume group, as well as between arterial and venous activated partial thromboplastin time values for all three discard volume groups (paired t-test, Bonferroni correction). CONCLUSION: We recommend that when drawing prothrombin time and activated partial thromboplastin time samples from an arterial line, a 5.3-mL discard volume be used.

Comparison of Standard and Derived 12-Lead Electrocardiograms Registrated by a Simplified 3-Lead Setting with Four Electrodes for Diagnosis of Coronary Angioplasty-induced Myocardial Ischaemia

2012 ◽  
Vol 8 (3) ◽  
pp. 179 ◽  
Author(s):  
Klaus Bonaventura ◽  
Ernst Wellnhofer ◽  
Eckart Fleck ◽  
◽  
◽  
...  
Keyword(s):  
Myocardial Infarction ◽  
Myocardial Ischaemia ◽  
Coronary Angioplasty ◽  
Patient Monitoring ◽  
Percutaneous Transluminal Coronary Angioplasty ◽  
Myocardial Infarction Patient ◽  
Cardiovascular Patients ◽  
Transluminal Coronary Angioplasty ◽  
Percutaneous Transluminal ◽  
Four Electrodes

Electrocardiograms (ECGs), myocardial infarction, patient monitoring, EASI lead ECG, percutaneous transluminal coronary angioplasty, four electrodes set 12-lead ECG, 12-lead ECG, cardiovascular patients

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