Monitoring Unfractionated Heparin in Adult Patients Undergoing Extracorporeal Membrane Oxygenation (ECMO): ACT, APTT, or ANTI-XA?
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...
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| Format: | Article |
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Wiley
2021-01-01
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| Series: | Critical Care Research and Practice |
| Online Access: | http://dx.doi.org/10.1155/2021/5579936 |
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| author | Tung Phi Nguyen Xuan Thi Phan Dai Quang Huynh Ha Thi Viet Truong Yen Nguyen Hai Le Tuan Manh Nguyen Quan Quoc Minh Du Thao Phuong Le Hai Ngoc Truong Thi Thi Ho Thao Thi Ngoc Pham |
| author_facet | Tung Phi Nguyen Xuan Thi Phan Dai Quang Huynh Ha Thi Viet Truong Yen Nguyen Hai Le Tuan Manh Nguyen Quan Quoc Minh Du Thao Phuong Le Hai Ngoc Truong Thi Thi Ho Thao Thi Ngoc Pham |
| author_sort | Tung Phi Nguyen |
| collection | DOAJ |
| description | 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. |
| format | Article |
| id | doaj-art-1e7c885785d741b88635d48acbb1954e |
| institution | Kabale University |
| issn | 2090-1305 2090-1313 |
| language | English |
| publishDate | 2021-01-01 |
| publisher | Wiley |
| record_format | Article |
| series | Critical Care Research and Practice |
| spelling | doaj-art-1e7c885785d741b88635d48acbb1954e2025-02-03T05:49:16ZengWileyCritical Care Research and Practice2090-13052090-13132021-01-01202110.1155/2021/55799365579936Monitoring Unfractionated Heparin in Adult Patients Undergoing Extracorporeal Membrane Oxygenation (ECMO): ACT, APTT, or ANTI-XA?Tung Phi Nguyen0Xuan Thi Phan1Dai Quang Huynh2Ha Thi Viet Truong3Yen Nguyen Hai Le4Tuan Manh Nguyen5Quan Quoc Minh Du6Thao Phuong Le7Hai Ngoc Truong8Thi Thi Ho9Thao Thi Ngoc Pham10Department of Intensive Care, Ho Chi Minh City University of Medicine and Pharmacy, Ho Chi Minh City, VietnamDepartment of Intensive Care, Ho Chi Minh City University of Medicine and Pharmacy, Ho Chi Minh City, VietnamDepartment of Intensive Care, Ho Chi Minh City University of Medicine and Pharmacy, Ho Chi Minh City, VietnamIntensive Care Unit, Cho Ray Hospital, Ho Chi Minh City, VietnamIntensive Care Unit, Cho Ray Hospital, Ho Chi Minh City, VietnamIntensive Care Unit, Cho Ray Hospital, Ho Chi Minh City, VietnamDepartment of Intensive Care, Ho Chi Minh City University of Medicine and Pharmacy, Ho Chi Minh City, VietnamDepartment of Intensive Care, Ho Chi Minh City University of Medicine and Pharmacy, Ho Chi Minh City, VietnamDepartment of Intensive Care, Ho Chi Minh City University of Medicine and Pharmacy, Ho Chi Minh City, VietnamIntensive Care Unit, Cho Ray Hospital, Ho Chi Minh City, VietnamDepartment of Intensive Care, Ho Chi Minh City University of Medicine and Pharmacy, Ho Chi Minh City, VietnamBackground. 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.http://dx.doi.org/10.1155/2021/5579936 |
| spellingShingle | Tung Phi Nguyen Xuan Thi Phan Dai Quang Huynh Ha Thi Viet Truong Yen Nguyen Hai Le Tuan Manh Nguyen Quan Quoc Minh Du Thao Phuong Le Hai Ngoc Truong Thi Thi Ho Thao Thi Ngoc Pham Monitoring Unfractionated Heparin in Adult Patients Undergoing Extracorporeal Membrane Oxygenation (ECMO): ACT, APTT, or ANTI-XA? Critical Care Research and Practice |
| title | Monitoring Unfractionated Heparin in Adult Patients Undergoing Extracorporeal Membrane Oxygenation (ECMO): ACT, APTT, or ANTI-XA? |
| title_full | Monitoring Unfractionated Heparin in Adult Patients Undergoing Extracorporeal Membrane Oxygenation (ECMO): ACT, APTT, or ANTI-XA? |
| title_fullStr | Monitoring Unfractionated Heparin in Adult Patients Undergoing Extracorporeal Membrane Oxygenation (ECMO): ACT, APTT, or ANTI-XA? |
| title_full_unstemmed | Monitoring Unfractionated Heparin in Adult Patients Undergoing Extracorporeal Membrane Oxygenation (ECMO): ACT, APTT, or ANTI-XA? |
| title_short | Monitoring Unfractionated Heparin in Adult Patients Undergoing Extracorporeal Membrane Oxygenation (ECMO): ACT, APTT, or ANTI-XA? |
| title_sort | monitoring unfractionated heparin in adult patients undergoing extracorporeal membrane oxygenation ecmo act aptt or anti xa |
| url | http://dx.doi.org/10.1155/2021/5579936 |
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