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- Title
Monitoring Unfractionated Heparin in Adult Patients Undergoing Extracorporeal Membrane Oxygenation (ECMO): ACT, APTT, or ANTI-XA?
- Authors
Nguyen, Tung Phi; Phan, Xuan Thi; Huynh, Dai Quang; Viet Truong, Ha Thi; Hai Le, Yen Nguyen; Nguyen, Tuan Manh; Minh Du, Quan Quoc; Le, Thao Phuong; Truong, Hai Ngoc; Ho, Thi Thi; Ngoc Pham, Thao Thi
- Abstract
<bold>Background: </bold>During ECMO, anticoagulants, in particular, unfractionated heparin (UFH), are commonly used and monitored by laboratory tests, including ACT, APTT, and anti-Xa level.<bold>Method: </bold>A single-center retrospective observational study was conducted on adult patients undergoing ECMO between January 2019 and January 2020 at a tertiary hospital. The correlations between ACT, APTT, anti-Xa, antithrombin, and UFH dose were assessed.<bold>Results: </bold>129 sets of measurements from 37 patients were obtained including ACT, APTT, anti-Xa, antithrombin, and UFH dose measured simultaneously. 102 out of 129 sets of values were interpreted as antithrombin deficiencies. The correlation coefficient between APTT and anti-Xa; ACT and anti-Xa are 0.72 and 0.33, respectively, p < 0.001. The patients with normal antithrombin levels exhibited a significant correlation between APTT and anti-Xa (r = 0.80, p < 0.001). ACT, on the other hand, was poorly correlated with UFH dose, whether there is AT deficiency or not. Anti-Xa and APTT are only moderately correlated with UFH dose in the group without antithrombin deficiency, with correlation coefficients of 0.62 and 0.57, respectively, p < 0.05.<bold>Conclusion: </bold>APTT value is strongly correlated with anti-Xa value, particularly in patients with normal antithrombin levels. However, the ACT value was poorly correlated with anti-Xa and not with the UFH dose. In groups without antithrombin deficiency, APTT and anti-Xa values only moderately correlated with UFH dose.
- Subjects
EXTRACORPOREAL membrane oxygenation; HEPARIN; ADULTS
- Publication
Critical Care Research & Practice, 2021, p1
- ISSN
2090-1305
- Publication type
journal article
- DOI
10.1155/2021/5579936