PMID- 32864461
OWN - NLM
STAT- PubMed-not-MEDLINE
LR  - 20240329
IS  - 2393-1809 (Print)
IS  - 2393-1817 (Electronic)
IS  - 2393-1817 (Linking)
VI  - 6
IP  - 3
DP  - 2020 Jul
TI  - Monitoring Anticoagulation with Unfractionated Heparin on Renal Replacement 
      Therapy. Which is the Best aPTT Sampling Site?
PG  - 159-166
LID - 10.2478/jccm-2020-0024 [doi]
AB  - BACKGROUND: Controlled anticoagulation is key to maintaining continuous blood 
      filtration therapies. Objective: The study aimed to compare different blood 
      sampling sites for activated partial thromboplastin time (aPTT) to evaluate 
      anticoagulation with unfractionated heparin (UFH) in continuous renal replacement 
      therapy (CRRT) and identify the most appropriate sampling site for safe patient 
      anticoagulation and increased filter life span. METHOD: The study was a 
      prospective observational single-centre investigation targeting intensive care 
      unit (ICU) patients on CRRT using an anticoagulation protocol based on patient 
      characteristics and a weight-based modified nomogram. Eighty-four patients were 
      included in the study. Four sampling sites were assessed: heparin free central 
      venous nondialysis catheter (CVC), an arterial line with heparinised flush 
      (Artery), a circuit access line (Access), and a circuit return line (Postfilter). 
      Blood was sampled from each of four different sites on every patient, four hours 
      after the first heparin bolus. aPTT was determined using a rapid clot detector, 
      point of care device. RESULTS: A high positive correlation was obtained for aPTT 
      values between CVC and Access sampling sites (r (84) =0.72; p <0 .05) and a low 
      positive correlation between CVC and Arterial sampling site (r (84) =0.46, p < 
      0.05). When correlated by artery age, the young Artery (1-3 day old) correlates 
      with CVC, Access and Postfilter (r (45) = 0.74, p >0.05). The aPTT values were 
      significantly higher at Postfilter and Arterial sampling site, older than three 
      days, compared to the CVC sampling site (p<0.05). CONCLUSION: Considering patient 
      bleeding risks and filter life span, the optimal sampling sites for safe 
      assessment of unfractionated heparin anticoagulation on CRRT during CVVHDF were 
      the central venous catheter using heparin free lavage saline solution, a 
      heparinised flushed arterial catheter not older than three days, and a circuit 
      access line.
CI  - (c) 2020 Florin Ioan Anton, Paul Adrian Rus, Natalia Hagau, published by Sciendo.
FAU - Anton, Florin Ioan
AU  - Anton FI
AD  - Regina Maria Hospital, Cluj-Napoca, Romania.
FAU - Rus, Paul Adrian
AU  - Rus PA
AD  - Iuliu Hatieganu University of Medicine and Pharmacy, Cluj-Napoca, Emergency 
      Clinical County Hospital, Cluj-Napoca, Romania.
FAU - Hagau, Natalia
AU  - Hagau N
AD  - Iuliu Hatieganu University of Medicine and Pharmacy, Cluj-Napoca, Regina Maria 
      Hospital, Cluj-Napoca, Romania.
LA  - eng
PT  - Journal Article
DEP - 20200811
PL  - Poland
TA  - J Crit Care Med (Targu Mures)
JT  - Journal of critical care medicine (Universitatea de Medicina si Farmacie din 
      Targu-Mures)
JID - 101706934
PMC - PMC7430360
OTO - NOTNLM
OT  - aPTT sampling sites
OT  - continuous renal replacement therapy
OT  - heparin
COIS- Conflict of interest None to declare.
EDAT- 2020/08/31 06:00
MHDA- 2020/08/31 06:01
PMCR- 2020/08/11
CRDT- 2020/09/01 06:00
PHST- 2020/02/25 00:00 [received]
PHST- 2020/06/26 00:00 [accepted]
PHST- 2020/09/01 06:00 [entrez]
PHST- 2020/08/31 06:00 [pubmed]
PHST- 2020/08/31 06:01 [medline]
PHST- 2020/08/11 00:00 [pmc-release]
AID - jccm-2020-0024 [pii]
AID - 10.2478/jccm-2020-0024 [doi]
PST - epublish
SO  - J Crit Care Med (Targu Mures). 2020 Aug 11;6(3):159-166. doi: 
      10.2478/jccm-2020-0024. eCollection 2020 Jul.