PMID- 35847800
OWN - NLM
STAT- PubMed-not-MEDLINE
LR  - 20220719
IS  - 2296-858X (Print)
IS  - 2296-858X (Electronic)
IS  - 2296-858X (Linking)
VI  - 9
DP  - 2022
TI  - An Agreement Study Between Point-of-Care and Laboratory Activated Partial 
      Thromboplastin Time for Anticoagulation Monitoring During Extracorporeal Membrane 
      Oxygenation.
PG  - 931863
LID - 10.3389/fmed.2022.931863 [doi]
LID - 931863
AB  - BACKGROUND: Laboratory activated partial thromboplastin time (LAB-aPTT) is a 
      widely used laboratory assay for monitoring unfractionated heparin (UFH) therapy 
      during extracorporeal membrane oxygenation (ECMO). But LAB-aPTT is confined to a 
      central laboratory, and the procedure is time-consuming. In comparison, 
      point-of-care aPTT (POC-aPTT) is a convenient and quick assay, which might be a 
      promising method for anticoagulation monitoring in ECMO. This study was aimed to 
      evaluate the agreement between POC-aPTT (hemochron Jr. Signature instruments) and 
      LAB-aPTT for anticoagulation monitoring in adult ECMO patients. METHODS: Data of 
      ECMO-supported adult patients anticoagulated with UFH in our institute from 
      January 2017 to December 2020 was retrospectively reviewed. POC-aPTT and LAB-aPTT 
      results measured simultaneously were paired and included in the analysis. The 
      correlation between POC-aPTT and LAB-aPTT was assessed using Spearman's 
      correlation coefficient. Bias between POC-aPTT and LAB-aPTT were described with 
      the Bland-Altman method. Influence factors for bias were identified using 
      multinomial logistic regression analysis. RESULTS: A total 286 pairs of aPTT 
      results from 63 patients were included in the analysis. POC-aPTT and LAB-aPTT 
      correlated weakly (r = 0.385, P < 0.001). The overall bias between POC-aPTT and 
      LAB-aPTT was 7.78 [95%CI (-32.49, 48.05)] s. The overall bias between POC-aPTT 
      and LAB-aPTT ratio (to normal value) was 0.54 [95%CI (-0.68, 1.76)]. A higher 
      plasma fibrinogen level [OR 1.353 (1.057, 1.733), P = 0.017] was associated with 
      a higher chance of POC-aPTT underestimating LAB-aPTT. While a lower plasma 
      fibrinogen level [OR 0.809 (0.679, 0.963), P = 0.017] and lower UFH rate [OR 
      0.928 (0.868, 0.992), P = 0.029] were associated with a higher chance of POC-aPTT 
      overestimating LAB-aPTT. CONCLUSION: The present study showed poor agreement 
      between POC-aPTT and LAB-aPTT. POC-aPTT was not suitable for anticoagulation 
      monitoring in adult ECMO patients.
CI  - Copyright (c) 2022 Teng, Yan, Liu, Lou, Zhang and Ji.
FAU - Teng, Yuan
AU  - Teng Y
AD  - Department of Cardiopulmonary Bypass, National Center for Cardiovascular 
      Diseases, Fuwai Hospital, Peking Union Medical College, Chinese Academy of 
      Medical Sciences, Beijing, China.
FAU - Yan, Shujie
AU  - Yan S
AD  - Department of Cardiopulmonary Bypass, National Center for Cardiovascular 
      Diseases, Fuwai Hospital, Peking Union Medical College, Chinese Academy of 
      Medical Sciences, Beijing, China.
FAU - Liu, Gang
AU  - Liu G
AD  - Department of Cardiopulmonary Bypass, National Center for Cardiovascular 
      Diseases, Fuwai Hospital, Peking Union Medical College, Chinese Academy of 
      Medical Sciences, Beijing, China.
FAU - Lou, Song
AU  - Lou S
AD  - Department of Cardiopulmonary Bypass, National Center for Cardiovascular 
      Diseases, Fuwai Hospital, Peking Union Medical College, Chinese Academy of 
      Medical Sciences, Beijing, China.
FAU - Zhang, Yang
AU  - Zhang Y
AD  - Center of Laboratory Medicine, National Center for Cardiovascular Diseases, Fuwai 
      Hospital, Peking Union Medical College, Chinese Academy of Medical Sciences, 
      Beijing, China.
FAU - Ji, Bingyang
AU  - Ji B
AD  - Department of Cardiopulmonary Bypass, National Center for Cardiovascular 
      Diseases, Fuwai Hospital, Peking Union Medical College, Chinese Academy of 
      Medical Sciences, Beijing, China.
LA  - eng
PT  - Journal Article
DEP - 20220629
PL  - Switzerland
TA  - Front Med (Lausanne)
JT  - Frontiers in medicine
JID - 101648047
PMC - PMC9276956
OTO - NOTNLM
OT  - activated partial thromboplastin time
OT  - anticoagulation
OT  - extracorporeal membrane oxygenation
OT  - point of care
OT  - unfractionated heparin
COIS- The authors declare that the research was conducted in the absence of any 
      commercial or financial relationships that could be construed as a potential 
      conflict of interest.
EDAT- 2022/07/19 06:00
MHDA- 2022/07/19 06:01
PMCR- 2022/06/29
CRDT- 2022/07/18 04:20
PHST- 2022/04/29 00:00 [received]
PHST- 2022/06/07 00:00 [accepted]
PHST- 2022/07/18 04:20 [entrez]
PHST- 2022/07/19 06:00 [pubmed]
PHST- 2022/07/19 06:01 [medline]
PHST- 2022/06/29 00:00 [pmc-release]
AID - 10.3389/fmed.2022.931863 [doi]
PST - epublish
SO  - Front Med (Lausanne). 2022 Jun 29;9:931863. doi: 10.3389/fmed.2022.931863. 
      eCollection 2022.