PMID- 33350327
OWN - NLM
STAT- MEDLINE
DCOM- 20210730
LR  - 20210730
IS  - 1938-2723 (Electronic)
IS  - 1076-0296 (Print)
IS  - 1076-0296 (Linking)
VI  - 26
DP  - 2020 Jan-Dec
TI  - Activated Clotting Time (ACT) for Monitoring of Low-Dose Heparin: Performance 
      Characteristics in Healthy Adults and Critically Ill Patients.
PG  - 1076029620975494
LID - 10.1177/1076029620975494 [doi]
LID - 1076029620975494
AB  - Dose adjustment of unfractionated heparin (UFH) anticoagulation is an important 
      factor to reduce hemorrhagic events. High doses of heparin can be monitored by 
      Activated Clotting Time (ACT). Because of limited information about the 
      monitoring of low-dose heparin we assessed monitoring by ACT, aPTT and anti-Xa. 
      Blood samples from healthy volunteers (n = 54) were treated ex vivo with 
      increasing UFH doses (0-0.4 IU/ml). Samples from ICU-patients (n = 60), were 
      drawn during continuous UFH infusion. Simultaneous ACT measurements were 
      performed using iSTAT and Hemochron. In UFH treated blood, iSTAT and Hemochron 
      showed a significant change of ACT at >/=0.075 IU/ml and >/=0.1 IU/ml UFH, 
      respectively. In ICU-patients no relationship between ACT and either UFH dose, 
      aPTT and anti-Xa was observed. Hemochron was affected by antithrombin and 
      platelet count. iSTAT was sensitive to CRP and hematocrit. A moderate correlation 
      was identified between UFH dose and aPTT (R(2) = 0.196) or anti-Xa (R(2) = 
      0.162). In heparin-spiked blood, ACT is sensitive to heparin at levels of >/=0.1 
      IU/ml heparin. In ICU-patients, ACT did not correlate with UFH dose or other 
      established methods. Both systems were differently influenced by certain 
      parameters.
FAU - Wehner, Johannes E
AU  - Wehner JE
AD  - Department of Hematology, Hemostasis, Oncology and Stem Cell Transplantation, 
      Hannover Medical School, Hannover, Germany.
FAU - Boehne, Martin
AU  - Boehne M
AD  - Department of Pediatric Cardiology and Intensive Care Medicine, Hannover Medical 
      School, Hannover, Germany.
FAU - David, Sascha
AU  - David S
AD  - Department of Nephrology and Hypertension, Hannover Medical School, Hannover, 
      Germany.
FAU - Brand, Korbinian
AU  - Brand K
AD  - Institute of Clinical Chemistry, Hannover Medical School, Hannover, Germany.
FAU - Tiede, Andreas
AU  - Tiede A
AD  - Department of Hematology, Hemostasis, Oncology and Stem Cell Transplantation, 
      Hannover Medical School, Hannover, Germany.
FAU - Bikker, Rolf
AU  - Bikker R
AUID- ORCID: 0000-0003-4914-7049
AD  - Institute of Clinical Chemistry, Hannover Medical School, Hannover, Germany.
LA  - eng
PT  - Journal Article
PT  - Observational Study
PL  - United States
TA  - Clin Appl Thromb Hemost
JT  - Clinical and applied thrombosis/hemostasis : official journal of the 
      International Academy of Clinical and Applied Thrombosis/Hemostasis
JID - 9508125
RN  - 0 (Anticoagulants)
RN  - 9005-49-6 (Heparin)
SB  - IM
MH  - Adult
MH  - Anticoagulants/*administration & dosage/*pharmacology/therapeutic use
MH  - Blood Coagulation/*drug effects
MH  - Critical Illness
MH  - Dose-Response Relationship, Drug
MH  - Female
MH  - Heparin/*administration & dosage/*pharmacology/therapeutic use
MH  - Humans
MH  - Male
MH  - Middle Aged
MH  - Whole Blood Coagulation Time
MH  - Young Adult
PMC - PMC7758671
OTO - NOTNLM
OT  - activated clotting time
OT  - anticoagulants
OT  - blood coagulation
OT  - blood coagulations tests
OT  - heparin
OT  - point-of care systems
COIS- Declaration of Conflicting Interests: The author(s) declared no potential 
      conflicts of interest with respect to the research, authorship, and/or 
      publication of this article.
EDAT- 2020/12/23 06:00
MHDA- 2021/07/31 06:00
PMCR- 2020/12/22
CRDT- 2020/12/22 08:42
PHST- 2020/12/22 08:42 [entrez]
PHST- 2020/12/23 06:00 [pubmed]
PHST- 2021/07/31 06:00 [medline]
PHST- 2020/12/22 00:00 [pmc-release]
AID - 10.1177_1076029620975494 [pii]
AID - 10.1177/1076029620975494 [doi]
PST - ppublish
SO  - Clin Appl Thromb Hemost. 2020 Jan-Dec;26:1076029620975494. doi: 
      10.1177/1076029620975494.