PMID- 15956240
OWN - NLM
STAT- MEDLINE
DCOM- 20050826
LR  - 20061013
IS  - 1060-0280 (Print)
IS  - 1060-0280 (Linking)
VI  - 39
IP  - 7-8
DP  - 2005 Jul-Aug
TI  - Anticoagulation monitoring part 2: Unfractionated heparin and 
      low-molecular-weight heparin.
PG  - 1275-85
AB  - OBJECTIVE: To review the availability, mechanisms, limitations, and clinical 
      application of point-of-care (POC) devices used in monitoring anticoagulation 
      with unfractionated heparin (UFH) and low-molecular-weight heparins (LMWHs). DATA 
      SOURCES: Articles were identified through a MEDLINE search (1966-August 2004), 
      device manufacturer Web sites, additional references listed in articles and Web 
      sites, and abstracts from scientific meetings. STUDY SELECTION AND DATA 
      EXTRACTION: English-language literature from clinical trials was reviewed to 
      evaluate the accuracy, reliability, and clinical application of POC monitoring 
      devices. DATA SYNTHESIS: The activated partial thromboplastin time (aPTT) and 
      activated clotting time (ACT) are common tests for monitoring anticoagulation 
      with UFH. Multiple devices are available for POC aPTT, ACT, and heparin 
      concentration testing. The aPTT therapeutic range for UFH will vary depending 
      upon the reagent and instrument employed. Although recommended by the American 
      College of Chest Physicians Seventh Conference on Antithrombotic and Thrombolytic 
      Therapy, establishing a heparin concentration-derived therapeutic range for UFH 
      is rarely performed. Additional research evaluating anti-factor Xa monitoring of 
      LMWHs using POC testing is necessary. CONCLUSIONS: Multiple POC devices are 
      available to monitor anticoagulation with UFH. For each test, there is some 
      variability in results between devices and between reagents used in the same 
      device. Despite these limitations, POC anticoagulation monitoring of UFH using 
      aPTT and, more often, ACT is common in clinical practice, particularly when 
      evaluating anticoagulation associated with interventional cardiology procedures 
      and cardiopulmonary bypass surgery.
FAU - Spinler, Sarah A
AU  - Spinler SA
AD  - Cardiovascular Division, Department of Medicine, Philadelphia College of 
      Pharmacy, University of Pennsylvania, Philadelphia, PA, USA. s.spinle@usip.edu
FAU - Wittkowsky, Ann K
AU  - Wittkowsky AK
FAU - Nutescu, Edith A
AU  - Nutescu EA
FAU - Smythe, Maureen A
AU  - Smythe MA
LA  - eng
PT  - Journal Article
PT  - Review
DEP - 20050614
PL  - United States
TA  - Ann Pharmacother
JT  - The Annals of pharmacotherapy
JID - 9203131
RN  - 0 (Anticoagulants)
RN  - 0 (Enoxaparin)
RN  - 0 (Heparin, Low-Molecular-Weight)
RN  - 9005-49-6 (Heparin)
SB  - IM
MH  - Anticoagulants/administration & dosage/pharmacokinetics/*therapeutic use
MH  - Drug Monitoring
MH  - Enoxaparin/pharmacology
MH  - Extracorporeal Circulation
MH  - Heparin/administration & dosage/pharmacokinetics/*therapeutic use
MH  - Heparin, Low-Molecular-Weight/administration & 
      dosage/pharmacokinetics/*therapeutic use
MH  - Humans
MH  - Point-of-Care Systems
MH  - Whole Blood Coagulation Time
RF  - 100
EDAT- 2005/06/16 09:00
MHDA- 2005/08/27 09:00
CRDT- 2005/06/16 09:00
PHST- 2005/06/16 09:00 [pubmed]
PHST- 2005/08/27 09:00 [medline]
PHST- 2005/06/16 09:00 [entrez]
AID - aph.1E524 [pii]
AID - 10.1345/aph.1E524 [doi]
PST - ppublish
SO  - Ann Pharmacother. 2005 Jul-Aug;39(7-8):1275-85. doi: 10.1345/aph.1E524. Epub 2005 
      Jun 14.