Articles: partial-thromboplastin-time.
-
In patients with acute myocardial infarction (AMI) receiving thrombolytic therapy and i.v. unfractionated heparin, anticoagulant levels are frequently outside the target range. We evaluated the effects on anticoagulant levels before (group A) and after (group B) the introduction of a heparin nomogram in consecutive AMI-patients, receiving thrombolytic therapy and adjunctive heparin treatment. The target activated partial thromboplastin time (aPTT) was defined as 60-90 s. ⋯ We concluded that the introduction of a nomogram resulted in significantly more patients with aPTTs within the target range. However, a substantial number of aPTTs before and after introduction of the nomogram were outside the target range. Moreover, this retrospective study shows that previously acquired prospective data (which showed a marked improvement of anticoagulation using a heparin nomogram) are not necessarily reproduced in the real life clinical setting.
-
Intensive care medicine · Nov 1998
Comparative Study Clinical Trial Retracted PublicationPoint-of-care (POC) measurement of coagulation after cardiac surgery.
Two different point-of-care (POC) systems for the monitoring of coagulation variables at the bedside were evaluated with regard to practicability, accuracy and costs. ⋯ Both POC analyzers may reduce the potential for preanalytical errors associated with coagulation measurements at the central laboratory, hasten TAT significantly and may improve patient therapy by reducing inappropriate administration of blood products.
-
Turnaround time for analysis of prothrombin time (PT) and activated partial thromboplastin time (APTT) by standard laboratory methods ranges between 40 min and several hours. The delay in obtaining the test results limits their clinical utility for treatment of perioperative coagulation disorders and adequate anti-coagulation therapy. In this study, we compared on-site coagulation testing (OCT) of whole blood, which takes about 3 min, with standard laboratory plasma coagulation tests by our institutional laboratory (LAB) to assess the accuracy of the OCT in a clinical setting (abdominal and postcardiac surgery). ⋯ On-site coagulation monitoring provides a rapid, convenient, and accurate assessment of coagulation that can both guide specific anti-coagulation therapy and optimize therapy control of coagulation disorders after cardiac and abdominal operations. As a consequence, OCT offers a valuable tool to reduce the inappropriate use of fresh frozen plasma and to improve cost-effectiveness.
-
Otolaryngol Head Neck Surg · Dec 1997
Value of preoperative prothrombin time/partial thromboplastin time as a predictor of postoperative hemorrhage in pediatric patients undergoing tonsillectomy.
Hemorrhage after tonsillectomy is a potentially lethal complication. Preoperative assessment consisting of prothrombin time (PT) and activated partial thromboplastin time (PTT) has been used to identify patients at risk for hemorrhage after tonsillectomy and adenoidectomy. We sought to assess the value of PT/PTT screening as a predictor of posttonsillectomy hemorrhage. ⋯ Preoperative PT/PTT provides no additional information than does a bleeding history for the general pediatric population undergoing tonsillectomy. This should only be done in selective cases where warranted by history.
-
In treating venous thromboembolic disorders, patient outcomes appear to correlate with heparin levels. Due to pharmacokinetic and pharmacodynamic variations, a relationship between heparin dose and level cannot be reliably predicted in individual patients. Some patients have low heparin levels despite therapeutic activated partial thromboplastin times (aPTTs), which may increase their risk for recurrent thromboembolism. Patients with high heparin requirements appear to have fewer bleeding episodes with heparin level-guided therapy. The aPTT does not reliably correlate with heparin blood concentrations or antithrombotic effects. Consequently, heparin therapy monitored with heparin levels may be more effective and safer. ⋯ The aPTT does not appear to be a useful surrogate for heparin levels. These findings suggest that the current recommendations on the use of heparin levels should be expanded.