PMID- 2177970
OWN - NLM
STAT- MEDLINE
DCOM- 19910312
LR  - 20190828
IS  - 0160-564X (Print)
IS  - 0160-564X (Linking)
VI  - 14
IP  - 6
DP  - 1990 Dec
TI  - Usefulness of thrombelastography for dosage monitoring of low molecular weight 
      heparin and unfractionated heparin during hemodialysis.
PG  - 413-5
AB  - Low molecular weight heparin (LMH) acts as an anticoagulation agent mainly 
      through its anti-activated coagulation factor X (Xa) activity. Thrombelastography 
      (TEG) is expected to be useful to monitor the dosage of LMH during hemodialysis 
      because reaction time on TEG (TEG-r) is considered to reflect blood 
      thromboplastin formation time, which depends on the formation of Xa. To test this 
      possibility, we compared the usefulness of TEG, activated coagulation time (ACT), 
      activated partial thromboplastin time (APTT), and anti-Xa activity in 28 
      hemodialysis patients using both conventional unfractionated heparin (UFH) and 
      LMH on separate dialysis procedures. Anti-Xa activity of LMH was comparable to 
      that of UFH when it was measured using both LMH and UFH as standards. Anti-Xa 
      activity, which theoretically depended on the heparin concentration in blood 
      samples, did not correlate with the degree of dialyzer clotting. The APTT 
      correlated well with anti-Xa activity in patients using LMH (r = 0.686, p less 
      than 0.01) and UFH (r = 0.906, p less than 0.01), but not with the degree of 
      dialyzer clotting. The TEG-r correlated well with the degree of dialyzer clotting 
      both in patients using LMH and those using UFH (measurements of samples obtained 
      from the venous side of the extracorporeal circuit) and weakly correlated with 
      anti-Xa activity in patients using LMH (r = 0.402, p less than 0.05). The ACT did 
      not correlate with the degree of dialyzer clotting or anti-Xa activity. These 
      results suggest that TEG-r reflects the efficacy of heparin in the 
      extra-corporeal blood circuit, whereas APTT mainly reflects heparin concentration 
      of the blood samples.(ABSTRACT TRUNCATED AT 250 WORDS)
FAU - Shinoda, T
AU  - Shinoda T
AD  - Shinshu University Hospital, Matsumoto, Japan.
FAU - Arakura, H
AU  - Arakura H
FAU - Katakura, M
AU  - Katakura M
FAU - Shirota, T
AU  - Shirota T
FAU - Nakagawa, S
AU  - Nakagawa S
LA  - eng
PT  - Clinical Trial
PT  - Comparative Study
PT  - Controlled Clinical Trial
PT  - Journal Article
PL  - United States
TA  - Artif Organs
JT  - Artificial organs
JID - 7802778
RN  - 0 (Factor Xa Inhibitors)
RN  - 0 (Heparin, Low-Molecular-Weight)
RN  - 9005-49-6 (Heparin)
SB  - IM
MH  - Factor Xa Inhibitors
MH  - Female
MH  - Heparin/administration & dosage/therapeutic use
MH  - Heparin, Low-Molecular-Weight/*administration & dosage/therapeutic use
MH  - Humans
MH  - Male
MH  - Middle Aged
MH  - Partial Thromboplastin Time
MH  - *Renal Dialysis
MH  - *Thrombelastography
EDAT- 1990/12/01 00:00
MHDA- 1990/12/01 00:01
CRDT- 1990/12/01 00:00
PHST- 1990/12/01 00:00 [pubmed]
PHST- 1990/12/01 00:01 [medline]
PHST- 1990/12/01 00:00 [entrez]
AID - 10.1111/j.1525-1594.1990.tb02996.x [doi]
PST - ppublish
SO  - Artif Organs. 1990 Dec;14(6):413-5. doi: 10.1111/j.1525-1594.1990.tb02996.x.