Anticoagulation monitoring during vascular surgery: accuracy of the Hemochron ® low range activated clotting time (ACT-LR)
| Autor: | S. Schlumberger, Marc Fischler, D. François, Ngai Liu, B. Szekely, K. Sievert, Benjamin Tremey |
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| Rok vydání: | 2006 |
| Předmět: |
Adult
Male medicine.medical_specialty medicine.drug_mechanism_of_action medicine.drug_class Factor Xa Inhibitor Activated clotting time Drug Administration Schedule Monitoring Intraoperative medicine Humans In patient Aged Intraoperative Care medicine.diagnostic_test Heparin business.industry Anticoagulant Anticoagulants Reproducibility of Results Middle Aged Vascular surgery Anesthesiology and Pain Medicine Coagulation Whole Blood Coagulation Time Anesthesia Female Blood Coagulation Tests Drug Monitoring business Vascular Surgical Procedures Factor Xa Inhibitors medicine.drug |
| Zdroj: | British Journal of Anaesthesia. 97:453-459 |
| ISSN: | 0007-0912 |
| Popis: | Activated clotting time (ACT) is currently used to monitor high concentrations of heparin anticoagulation. A new instrument, the Hemochron Jr Signature device, has been specifically designed to measure ACT in low-range heparin plasma concentrations (ACT-LR). The purpose of this study was to compare ACT-LR with anti-Xa activity in patients receiving low-dose i.v. heparin during vascular surgery.Thirty patients, undergoing arterial vascular surgery, were included in the study and received unfractionated heparin (initial dose 50 u kg(-1)). One hundred and thirty-two pairs of blood samples were simultaneously collected during surgery to determine ACT-LR and anti-Xa activity. Pearson correlation, Kappa test, ROC curve and a specific clinical interpretation of the correlation were performed.ACT-LR ranged from 68 to 380 s, anti-Xa activity from 0 to 1.45 u ml(-1). We observed a strong correlation between anti-Xa activity and ACT-LR (r(2)=0.87; P0.0001). Accuracy of ACT-LR was good for anti-Xa activity up to 0.6 u ml(-1) (Kappa, 0.94; accuracy, 97%) and 0.8 u ml(-1) (Kappa, 0.79; accuracy, 90%), and poor for anti-Xa activity above 1 u ml(-1) (Kappa, 0.59). A clinical interpretation of the correlation graph found 98% of measured ACT-LR values to be accurate.Hemochron Jr Signature provides measurements of ACT-LR, which are accurate for monitoring heparin anticoagulation at anti-Xa activity below 0.8 u ml(-1). |
| Databáze: | OpenAIRE |
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