An ex vivo comparison of partial thromboplastin time and activated clotting time for heparin anticoagulation in an ovine model

被引:5
作者
Berk, Zachary B. K. [1 ]
Shah, Aakash [1 ]
Sun, Wenji [1 ]
Griffith, Bartley P. [1 ]
Wu, Zhongjun J. [1 ]
机构
[1] Univ Maryland, Sch Med, Dept Surg, Div Cardiac Surg, Baltimore, MD 21201 USA
关键词
ACT; anticoagulation; aPTT; ECMO; heparin; mechanically assisted circulation; ovine; ANTIFACTOR XA LEVELS; THERAPY; SHEEP;
D O I
10.1111/aor.14094
中图分类号
R318 [生物医学工程];
学科分类号
0831 ;
摘要
Background Sheep are a primary model of mechanical circulatory support (MCS) with heparin anticoagulation therapy frequently being monitored by activated clotting time (ACT) due to ease and cost. In patients undergoing long-term heparin therapy, other anticoagulation monitoring strategies, such as activated partial thromboplastin time (aPTT), have proven to be more reliable indicators for the adequacy of anticoagulation, frequently determined by heparin concentration. As there is a paucity of similar studies in sheep, we sought to investigate the correlation between heparin concentration and ACT and aPTT using whole sheep blood in an ex vivo model. Methods Fresh whole blood was serially drawn from an adult female Dorset-hybrid sheep and aliquots were placed into tubes containing heparin saline solutions with concentrations ranging from 0 to 7.81 U heparin per mL of whole blood. ACT and aPTT values were measured on each of the samples. The experiment was performed four times with the same animal. A simple linear regression was performed to determine correlation, and subgroup analysis was performed on low versus high heparin concentrations typically seen in human patients on long-term MCS, such as extracorporeal membrane oxygenation (ECMO), versus cardiopulmonary bypass, respectively. Results aPTT measurements versus the heparin concentration had an R-2 = 0.7295. ACT measurements versus the heparin concentration had a R-2 = 0.4628. aPTT measurements versus the ACT measurements had a R-2 = 0.2974. The strength of the correlation between aPTT and heparin concentration increased at low heparin concentrations (R-2 = 0.8392). Conclusion aPTT had a more reliable correlation to heparin concentration and thus anticoagulation level than ACT. This was particularly true at lower heparin concentrations, similar to ranges seen for patients on ECMO. The correlation between aPTT and ACT values was poor. Further in vivo studies should be performed to confirm our results.
引用
收藏
页码:501 / 505
页数:5
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[31]   Competition of unfractionated heparin and idraparinux on activated partial thromboplastin time and effect of exogenous antithrombin [J].
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[37]   Comparison of activated clotting times to heparin management test for adequacy of heparin anticoagulation in percutaneous transluminal coronary angioplasty [J].
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