PMID- 29503117
OWN - NLM
STAT- MEDLINE
DCOM- 20190116
LR  - 20190116
IS  - 1532-8422 (Electronic)
IS  - 1053-0770 (Linking)
VI  - 32
IP  - 4
DP  - 2018 Aug
TI  - Assessment of Heparin Anticoagulation Measured Using i-STAT and Hemochron 
      Activated Clotting Time.
PG  - 1603-1608
LID - S1053-0770(18)30031-4 [pii]
LID - 10.1053/j.jvca.2018.01.027 [doi]
AB  - OBJECTIVE: Adequate anticoagulation, measured using activated clotting time 
      (ACT), is important during vascular and cardiac surgeries. Unfractionated heparin 
      is the most common anticoagulant used. The purpose of this analysis was to 
      compare the i-STAT ACT (iACT) to the Hemochron ACT (hACT), both of which were 
      then compared to anti-factor Xa (anti-Xa) assay, a representation of heparin 
      level and activity. DESIGN: Prospective study. SETTING: Tertiary care 
      cardiovascular center. PARTICIPANTS: Eleven consecutive elective adult cardiac 
      surgical patients. INTERVENTIONS: Prior to cardiopulmonary bypass, ACTs were 
      measured using i-STAT and Hemochron technologies and compared to each other and 
      to anti-Xa assay prior to and during a cumulative administration of heparin. Data 
      were compared using bias analyses. MEASUREMENTS AND MAIN RESULTS: Heparin (300 
      U/kg) was administered in quarterly doses. Coagulation labs were collected prior 
      to and 3 minutes after each quarterly dose of heparin. The baseline ACTs for 
      i-STAT and Hemochron were 147 and 142 seconds, respectively. A significant 
      association was found between iACT and hACT (p = 0.002). The iACT measurements 
      underestimated hACT at ACT levels >180 seconds or anti-Xa levels >0.75 U/mL. No 
      significant difference was found between ACT data at anti-Xa levels <0.5 U/mL. 
      CONCLUSION: There was a good association between the iACT and hACT; however, the 
      2 tests are not equivalent. Overall, the iACT underestimated the hACT. Agreement 
      between the ACT technologies was good at lower ACTs and anti-Xa levels, but 
      declined with an anti-Xa >0.75 U/mL.
CI  - Copyright (c) 2018 Elsevier Inc. All rights reserved.
FAU - Maslow, Andrew
AU  - Maslow A
AD  - Department of Anesthesiology, Rhode Island Hospital, Needham, MA. Electronic 
      address: amaslow@rcn.org.
FAU - Chambers, Alison
AU  - Chambers A
AD  - Department of Biostatistics, Rhode Island Hospital, Needham, MA.
FAU - Cheves, Tracey
AU  - Cheves T
AD  - Department of Hematology, Rhode Island Hospital, Needham, MA.
FAU - Sweeney, Joseph
AU  - Sweeney J
AD  - Department of Hematology, Rhode Island Hospital, Needham, MA.
LA  - eng
PT  - Journal Article
DEP - 20180131
PL  - United States
TA  - J Cardiothorac Vasc Anesth
JT  - Journal of cardiothoracic and vascular anesthesia
JID - 9110208
RN  - 0 (Anticoagulants)
RN  - 9005-49-6 (Heparin)
SB  - IM
MH  - Anticoagulants/*pharmacology
MH  - Blood Coagulation/*drug effects/physiology
MH  - Blood Coagulation Tests/methods
MH  - Heparin/*pharmacology
MH  - Humans
MH  - Monitoring, Intraoperative/*methods
MH  - Prospective Studies
MH  - Whole Blood Coagulation Time/methods
OTO - NOTNLM
OT  - activated clotting time
OT  - anti-Xa
OT  - anticoagulation
OT  - heparin
OT  - i-STAT
EDAT- 2018/03/06 06:00
MHDA- 2019/01/17 06:00
CRDT- 2018/03/06 06:00
PHST- 2017/09/22 00:00 [received]
PHST- 2018/03/06 06:00 [pubmed]
PHST- 2019/01/17 06:00 [medline]
PHST- 2018/03/06 06:00 [entrez]
AID - S1053-0770(18)30031-4 [pii]
AID - 10.1053/j.jvca.2018.01.027 [doi]
PST - ppublish
SO  - J Cardiothorac Vasc Anesth. 2018 Aug;32(4):1603-1608. doi: 
      10.1053/j.jvca.2018.01.027. Epub 2018 Jan 31.