A Quick Anti-Xa-Activity-Based Whole Blood Coagulation Assay for Monitoring Unfractionated Heparin During Cardiopulmonary Bypass: A Pilot Investigation

@article{Hansen2000AQA,
  title={A Quick Anti-Xa-Activity-Based Whole Blood Coagulation Assay for Monitoring Unfractionated Heparin During Cardiopulmonary Bypass: A Pilot Investigation},
  author={R Hansen and Andreas Koster and Marian Kukucka and Fritz Mertzlufft and Hermann Kuppe},
  journal={Anesthesia \& Analgesia},
  year={2000},
  volume={91},
  pages={533–538}
}
We developed a quick and easy method to perform anti-Xa-activity-based whole blood assay and assessed its reliability for online monitoring of unfractionated heparins (UFHs) during cardiopulmonary bypass. Seventy-five microliters of a mixture of 1:3 large- and small-range Heptest®™ reagent were transferred into blank cartridges of the ACT II device. The plastic flags for clot detection and stirring the sample and reagent were inserted and overlaid with 75 &mgr;L of Recalmix for recalcification… Expand
Quantification of unfractionated heparin in human plasma and whole blood by means of novel fluorogenic anti-FXa assays.
TLDR
Novel and sensitive plate-based fluorogenic anti-factor Xa (FXa) assays were investigated to quantify unfractionated heparin (UFH) in human plasma and whole blood within the therapeutic ranges of 0-1.6 U/mL and 0-0.8 U/ mL, which could assist diagnostic laboratories towards improved monitoring of UFH therapy. Expand
Heparin monitoring during cardiopulmonary bypass surgery using the one-step point-of-care whole blood anti-factor-Xa clotting assay heptest-POC-Hi.
TLDR
The HPOCH seems to be a promising new tool for specific on-site measurement of heparin activities in whole blood during CPB, and bias analysis showed that theHPOCH and Coatest hepar in could not be used interchangeably. Expand
The Plasma Supplemented Modified Activated Clotting Time for Monitoring of Heparinization During Cardiopulmonary Bypass: A Pilot Investigation
TLDR
The plasma mACT provided an improved correlation to chromogenically measured levels of anti-Xa activity during CPB, which most likely results from a correction of the effects of the impairment of the coagulation system caused by hemodilution and consumption of procoagulants on extracorporeal surfaces. Expand
Measurement of Non–Vitamin K Antagonist Oral Anticoagulants in Patient Plasma Using Heptest-STAT Coagulation Method
TLDR
A high correlation of the Heptest-STAT coagulation assay with chromogenic assays for factor Xa inhibiting NoACs and acceptably good correlation with thrombin inhibiting NOACs was demonstrated in plasma samples of patients on treatment. Expand
Overview of Heparin and Protamine Management and Dosing Regimens in Pediatric Cardiac Surgical Patients
TLDR
A technique for heparin and protamine dosing with determination ofHeparin concentrations, may remove many variables associated with pediatric cardiac surgery that requires cardiopulmonary bypass and may provide clinicians with new therapies to achieve better anticoagulation for patients and consequently better outcomes. Expand
STS/SCA/AmSECT Clinical Practice Guidelines: Anticoagulation during Cardiopulmonary Bypass.
TLDR
This clinical practice guideline was written with the intent to fill the evidence gap and to establish best practices in anticoagulation for CPB using the available evidence and will serve as a resource and will stimulate investigators to conduct more research and expand upon the evidence base. Expand
The Society of Thoracic Surgeons, The Society of Cardiovascular Anesthesiologists, and The American Society of ExtraCorporeal Technology: Clinical Practice Guidelines-Anticoagulation During Cardiopulmonary Bypass.
TLDR
This guideline was written with the intent to fill the evidence gap and to establish best practices in anticoagulation therapy for CPB using the available evidence and will serve as a resource and will stimulate investigators to conduct more research and to expand on the evidence base. Expand
The Society of Thoracic Surgeons, The Society of Cardiovascular Anesthesiologists, and The American Society of ExtraCorporeal Technology: Clinical Practice Guidelines—Anticoagulation During Cardiopulmonary Bypass
TLDR
This clinical practice guideline was written with the intent to fill the evidence gap and to establish best practices in anticoagulation therapy for CPB using the available evidence and will serve as a resource and will stimulate investigators to conduct more research and to expand on the evidence base. Expand
Preparation and anticoagulant properties of heparin-like electrospun membranes from carboxymethyl chitosan and bacterial cellulose sulfate.
TLDR
The clotting time and platelet adhesion experiments expressed the anticoagulant properties of CPBS and an inflammatory response was determined according to activation of the macrophages seeded onto the membranes. Expand
Platelet Glycoprotein IIb/IIIa Inhibitors in Cardiovascular Disease
TLDR
The present study focused on the use of Abciximab in Therapy-Resistant Unstable Angina trials and the clinical and Angiographic results of the CAPTURE Pilot Trial and the CAPtURE Study. Expand
...
1
2
...

References

SHOWING 1-10 OF 16 REFERENCES
Measurement of heparin concentration in whole blood with the Hepcon/HMS device does not agree with laboratory determination of plasma heparin concentration using a chromogenic substrate for activated factor X.
TLDR
Monitoring of heparin concentrations during bypass with the Hepcon/HMS device cannot be recommended because differences well outside the predetermined limits of agreement and clearly unacceptable for clinical purposes are found. Expand
The impact of heparin concentration and activated clotting time monitoring on blood conservation. A prospective, randomized evaluation in patients undergoing cardiac operation.
TLDR
Indirect evidence for coagulation factor consumption was demonstrated in control patients by more prolonged whole blood prothrombin time and activated partial thromboplastin time values after cardiopulmonary bypass when compared with values obtained in the intervention group. Expand
Comparison of activated coagulation time and whole blood heparin measurements with laboratory plasma anti-Xa heparin concentration in patients having cardiac operations.
TLDR
A weak correlation between activated clotting time measurements and plasma heparin concentration is evident during the cardiopulmonary bypass period, probably because of the influence of both reduced hematocrit and temperature on the activated clotbing time assay. Expand
Correlation of ACT as measured with three commercially available devices with circulating heparin level during cardiac surgery.
TLDR
It is concluded that all automated devices tested demonstrated an inability to predict circulating heparin at levels necessary for CPB, and that these discrepancies become magnified during CPB procedures. Expand
Protamine Reversal of Heparin Affects Platelet Aggregation and Activated Clotting Time After Cardiopulmonary Bypass
TLDR
It was found that excess protamine prolonged the activated clotting time and altered platelet function after cardiopulmonary bypass, whereas heparin antagonists, such as recombinant platelet factor 4 and hexadimethrine, exhibited a wider therapeutic range without adversely affecting the activated clogging time. Expand
More effective suppression of hemostatic system activation in patients undergoing cardiac surgery by heparin dosing based on heparin blood concentrations rather than ACT.
TLDR
Maintenance of higher patient-specific heparin concentrations during CPB more effectively suppresses excessive hemostatic system activation than do standard heParin doses chosen based on measurement of ACT, which may explain the significant reduction in perioperative blood loss and blood product use. Expand
Low-dose protamine based on heparin-protamine titration method reduces platelet dysfunction after cardiopulmonary bypass.
TLDR
Low-dose administration of protamine, based on a heparin-protamine titration method, restores not only the blood coagulation but also the platelet responses to thrombin and attenuates platelet alpha-granule secretion during heparIn neutralization. Expand
Response to heparinization in adults and children undergoing cardiac operations.
TLDR
Empirical heparin administration (3 mg/kg) does not result in "steady-state" anticoagulation during cardiopulmonary bypass, and empirical administration of protamine takes no account of interindividual differences inHeparin sensitivity and biological half-life, which may be assessed using the Hepcon HMS. Expand
Increased accuracy and precision of heparin and protamine dosing reduces blood loss and transfusion in patients undergoing primary cardiac operations.
TLDR
It is quite possible that only marginal if any improvement in hemostasis may be found in patients having primary, uncomplicated cardiac operation with the addition of more costly drugs or equipment, and it is against this background that the efficacy of additional drugs or Equipment should be assessed. Expand
Anticoagulation and anticoagulation reversal with cardiac surgery involving cardiopulmonary bypass: an update.
TLDR
New modalities of improving suppression of excess thrombin generation during CPB include use of heparin-bonded CPB circuits, hepar in cofactor II or related analogs, supplemental antithrombin III, directThrombin inhibitors (eg, hirudin, argatroban), and inhibitors of the contact and tissue factor pathways. Expand
...
1
2
...