PMID- 33769995
OWN - NLM
STAT- MEDLINE
DCOM- 20210531
LR  - 20230821
IS  - 1538-943X (Electronic)
IS  - 1058-2916 (Linking)
VI  - 67
IP  - 4
DP  - 2021 Apr 1
TI  - Activated Partial Thromboplastin Time Versus Anti-Factor Xa Monitoring of Heparin 
      Anticoagulation in Adult Venoarterial Extracorporeal Membrane Oxygenation 
      Patients.
PG  - 411-415
LID - 10.1097/MAT.0000000000001246 [doi]
AB  - The preferred assay for measuring and adjusting unfractionated heparin (UFH) 
      infusion to achieve optimal outcomes during extracorporeal membrane oxygenation 
      (ECMO) is not well established. This retrospective cohort study explored safety 
      and efficacy outcome differences between anti-factor Xa (anti-Xa) and activated 
      partial thromboplastin time (aPTT) for UFH in adult venoarterial ECMO. Forty-one 
      patients were included and analyzed. The UFH rate at first goal and time to goal 
      were both higher in the aPTT versus anti-Xa cohort but did not achieve 
      statistical significance (12.14 vs. 9.58 unit/kg/hour (p = 0.29), 20.22 vs. 12.05 
      hours (p = 0.11)). The aPTT cohort was in target goals 35.0% of the time versus 
      47.7% in the anti-Xa cohort (p = 0.13), above goal 41.0% vs. 17.3% (p = 0.02), 
      and below-goal 24.0% versus 35.0% of the time (p = 0.34). Minimum heparin rates 
      in the aPTT cohort were 6.28 vs. 3.33 unit/kg/hour in the anti-Xa cohort (p = 
      0.07), and the maximum UFH rate was 18.77 unit/kg/hour vs. 15.48 unit/kg/hour (p 
      = 0.10). Our findings suggest that aPTT monitoring may result in a delay to 
      target attainment, higher UFH rates, and overall exposure.
CI  - Copyright (c) ASAIO 2020.
FAU - Kulig, Caitlin E
AU  - Kulig CE
AUID- ORCID: 0000-0001-5109-5562
AD  - University of California, Davis Medical Center, Sacramento, California.
FAU - Schomer, Kendra J
AU  - Schomer KJ
FAU - Black, Hugh B
AU  - Black HB
FAU - Dager, William E
AU  - Dager WE
LA  - eng
PT  - Journal Article
PL  - United States
TA  - ASAIO J
JT  - ASAIO journal (American Society for Artificial Internal Organs : 1992)
JID - 9204109
RN  - 0 (Anticoagulants)
RN  - 0 (Factor Xa Inhibitors)
RN  - 9005-49-6 (Heparin)
SB  - IM
MH  - Adult
MH  - Anticoagulants/*administration & dosage
MH  - Blood Coagulation/drug effects
MH  - Cohort Studies
MH  - Drug Monitoring
MH  - *Extracorporeal Membrane Oxygenation
MH  - Factor Xa Inhibitors/*blood
MH  - Female
MH  - Heparin/*administration & dosage
MH  - Humans
MH  - Male
MH  - Middle Aged
MH  - *Partial Thromboplastin Time
MH  - Retrospective Studies
COIS- Disclosure: The authors have no conflicts of interest to report.
EDAT- 2021/03/27 06:00
MHDA- 2021/06/01 06:00
CRDT- 2021/03/26 17:18
PHST- 2021/03/26 17:18 [entrez]
PHST- 2021/03/27 06:00 [pubmed]
PHST- 2021/06/01 06:00 [medline]
AID - 00002480-202104000-00009 [pii]
AID - 10.1097/MAT.0000000000001246 [doi]
PST - ppublish
SO  - ASAIO J. 2021 Apr 1;67(4):411-415. doi: 10.1097/MAT.0000000000001246.