A rapid bedside method for the control of heparin therapy

Blakely, J. A.

doi:10.1016/0002-8703(69)90455-4

Cited by 5 publications

(5 citation statements)

References 6 publications

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“…Radiolab elled hep arin-35 8 can be detect ed easily after intravenous administration and provides useful information on t he blood disappearance time and tissue distribution of heparin (7), but is hazardous for clinical use. Both the glass clotting time (CT) and activated partial thromboplastin test (APTT) are used in controlling h eparin anticoagulation (2,4,18,20), but the usefulness of both tests is n ecessarily limited by their sensitivity to small amounts of heparin (Fig. 1and5).…”

Section: Discussionmentioning

confidence: 99%

A Simple Technique for the Measurement of Plasma Heparin Concentration during Anticoagulant Therapy

Marder¹

1970

Thromb Haemost

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SummaryBlood is incoagulable for several hours after therapeutic doses of intravenous heparin when tested by the glass clotting time (CT) or activated partialthromboplastin test (APTT). A simple modification of the APTT is described which allows the quantitative measurement of plasma heparin levels at any time during therapy. In principal the test plasma is diluted in normal plasma before assay, thereby reducing the heparin concentration to a range which can be measured by the APTT. The corresponding plasma heparin concentration is estimated by reference to a single standard curve which applies for concentrationsfrom 0.1 to 10 I.U./ml of plasma. Since all samples are diluted in normal plasma, storage of blood at 4° or even 37° for up to 48 h does not significantly alter the results. The assay is applied in the study of plasma heparin disappearance time and in the control of anticoagulant therapy forthromboembolic disease.

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Section: Discussionmentioning

confidence: 99%

A Simple Technique for the Measurement of Plasma Heparin Concentration during Anticoagulant Therapy

Marder¹

1970

Thromb Haemost

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“…Indeed its widest use, in the USA, is to monitor hepa rin therapy during extracorporeal circulation and coronary angioplasty [25], The test is essentially an aPTT carried out on whole blood. Like the aPTT it covers an acceptable range of heparin levels.…”

Section: Activated Clotting Timementioning

confidence: 99%

Laboratory Assessment of Antithrombotic Therapy: What Tests and If So Why?

Kher¹,

Dieri

Hemker

et al. 1997

Pathophysiol Haemos Thromb

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A critical review is given of the tests available for the assessment of the action of anticoagulants, such as heparins, oral anticoagulants and direct thrombin inhibitors, in patients under antithrombotic therapy. The principle of action and the performance of the thromboplastm time (PT), the activated partial thromboplastin time (aPTT), the whole blood clotting time, the thrombin time, the ecarin clotting time and the endogenous thrombin potential (ETP) is discussed, as well as the evidence behind the accepted therapeutic ranges. The two most common tests, PT and aPTT, respond in an essentially different way to clinically effective anticoagulation with hepa-rin and with oral anticoagulants. This means that they covar-iate with, but do not themselves represent the essential parameter influenced by anticoagulation. The experimental basis for the widely accepted two times prolongation of the aPTT as an indicator for adequate anticoagulation is shown to be meagre in the case of unfractionated heparin and lacking for the other anticoagulants. Common sources for error in the interpretation of anti-factor Xa- and anti-thrombin activity of heparins are indicated. Extensive experience with new tests like the ecarin clotting time and the ETP is still lacking. On the basis of preliminary data and in view of the importance of the enzymatic action of thrombin in the pathogenesis of thrombosis, the ETP is considered a possible candidate for a common parameter to assess different types of anticoagulants.

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“…None would appear to be better than the WBCT and all require to be performed in the laboratory. Under experimental conditions the whole blood activated partial thromboplastin time ('activated clotting time' or AcCe) is a bedside test which seems to correlate well with the WBCI, and to have certain advantages (Blakely, 1969;Estes, 1970). A slightly modified version of this test was compared with the WBCT during clinical control of heparin therapy.…”

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confidence: 99%