Articles: partial-thromboplastin-time.
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Critical care medicine · Feb 2004
Utility of activated partial thromboplastin time waveform analysis for identification of sepsis and overt disseminated intravascular coagulation in patients admitted to a surgical intensive care unit.
An abnormality of the optical transmission waveform obtained during measurement of the activated partial thromboplastin time (aPTT) has been described in association with overt disseminated intravascular coagulation. This abnormality, a biphasic waveform, is caused by the in vitro formation of Ca2+-induced complexes between very low density lipoprotein and C-reactive protein. We have evaluated the diagnostic utility of aPTT waveform analysis for identifying patients with overt disseminated intravascular coagulation and sepsis. ⋯ As an adjunct to routine coagulation testing in intensive care unit patients, aPTT waveform analysis is an elegant means for the rapid and highly specific identification of patients with sepsis.
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Comparative Study
Mechanism for shortening PT and APTT in dogs and rats--effect of fibrinogen on PT and APTT--.
The possible mechanisms for shortening prothrombin time (PT) and activated partial thromboplastin time (APTT) were investigated using citrated plasma from rats and dogs in vitro, especially focusing on increased fibrinogen concentrations. When purified canine fibrinogen was added to citrated canine plasma at final concentrations of 2, 4 and 8 mg/mL, PT and APTT were significantly shortened. ⋯ In citrated rat plasma, while purified rat fibrinogen had no effect on PT or APTT at final concentrations of 2, 4 and 8 mg/mL, it did shorten TT. These results suggest that an increased concentration of fibrinogen is a possible mechanism to shorten PT and APTT in dogs, but not in rats.
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Pediatric emergency care · Aug 2003
Prolonged partial thromboplastin times in children with fever and petechiae without bacteremia or sepsis.
In a prior uncontrolled study, 23% of children with fever and petechiae without bacteremia or sepsis had a prolonged partial thromboplastin time (PTT). We attempted to validate this finding by comparing the PTTs of children with fever and petechiae who were neither septic nor bacteremic with those of children without fever and petechiae. ⋯ Children with fever and petechiae without bacteremia or sepsis are more likely than controls to have prolonged partial thromboplastin time.
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Antithrombotic therapy with intravenous heparin in conjunction with aspirin reduces negative cardiovascular (CV) outcomes in patients with acute coronary syndromes. The need for a therapeutic range with the activated partial thromboplastin time (APTT) has not been validated in patients with arterial thrombosis who receive heparin. Therefore, it is unclear whether there is an association between recurrent CV events and low APTT values and between bleeding and high APTT values. ⋯ In patients with acute coronary syndromes without ST elevation who are treated with intravenous heparin, our findings justify regular APTT monitoring to minimize recurrent ischemic events and bleeding.
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Meta Analysis
Suboptimal monitoring and dosing of unfractionated heparin in comparative studies with low-molecular-weight heparin.
Site-specific validation of the activated partial thromboplastin time (aPTT) therapeutic range is required to ensure administration of the optimal dose of unfractionated heparin. Therapeutic ranges of 1.5 to 2.5 times the control value are subtherapeutic for most modern aPTT reagents. ⋯ Most studies monitored unfractionated heparin inappropriately. This shortcoming could be responsible for the reduced efficacy of unfractionated heparin in clinical trials.