TITLE

Evaluation of Heparin Assay for Coagulation Management in Newborns Undergoing ECMO

AUTHOR(S)
Khaja, Wassia A.; Bilen, Ozlem; Lukner, Ralf B.; Edwards, Rachel; Teruya, Jun
PUB. DATE
December 2010
SOURCE
American Journal of Clinical Pathology;Dec2010, Vol. 134 Issue 6, p950
SOURCE TYPE
Academic Journal
DOC. TYPE
Article
ABSTRACT
The objective was to identify the usefulness of heparin level by anti--factor Xa (anti-Xa) assay vs activated partial thromboplastin time (PTT) or activated clotting time (ACT) in neonates undergoing extracorporeal membrane oxygenation (ECMO). A retrospective record review of 21 patients in the neonatal intensive care unit (mean ECMO initiation age, 2 days; range, 0-4 days; male/female ratio, 1:1) undergoing ECMO from 2006 to 2008 was performed. Linear regression correlations between anti-Xa, PTT, and ACT were determined by extrapolating PTT and ACT therapeutic ranges that corresponded with the ECMO heparin target range of 0.3 to 0.6 U/mL. Pearson correlation coefficients between heparin levels and PTT (-0.903 to 0.984), PTT less than 40 seconds after correction using PTT-heparinase (-0.903 to 1.000), and ACT (-0.951 to 0.891) in this patient population were widely variable. Inconsistency of PTT and ACT therapeutic ranges corresponding to heparin levels of 0.3 to 0.6 U/mL prompts a multifactorial approach to ECMO management because no single laboratory test can be used to determine appropriate anticoagulation management.
ACCESSION #
70091355

 

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