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  • 标题:Monitoring Unfractionated Heparin in Adult Patients Undergoing Extracorporeal Membrane Oxygenation (ECMO): ACT, APTT, or ANTI-XA?
  • 本地全文:下载
  • 作者:Tung Phi Nguyen ; Xuan Thi Phan ; Dai Quang Huynh
  • 期刊名称:Critical Care Research and Practice
  • 印刷版ISSN:2090-1305
  • 电子版ISSN:2090-1313
  • 出版年度:2021
  • 卷号:2021
  • 页码:1-7
  • DOI:10.1155/2021/5579936
  • 出版社:Hindawi Publishing Corporation
  • 摘要:Background. During ECMO, anticoagulants, in particular, unfractionated heparin (UFH), are commonly used and monitored by laboratory tests, including ACT, APTT, and anti-Xa level. Method. 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. Results. 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 . Conclusion. 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.
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