A novel methodology for low-range heparin detection

Abstract

Unfractionated heparin is used in multiple clinical settings. Its overdosing and underdosing and residual effect after suboptimal reversal must be adequately recognised. This mandates precise monitoring of low-range activity. Although applicable bedside and widely used, monitoring with activated clotting times (ACT) is imprecise. 1 Anti-Xa activity assays are recognised as laboratory standard but are not point-of-care tests (POCT). 2 Viscoelastic tests (VET) provide a broad bedside view of coagulation. 3 ROTEM offers a HEPTEM/INTEM clotting time (CT) ratio, and Sonoclot, another VET, proposes glass bead ACT (gbACT) for heparin detection. 4,5 In a previous observational study, we identified a novel potential Sonoclot parameter: the slope-45. 6 We compared the performance of these tests in identifying isolated lowrange heparin.

Protamine dosing in cardiac surgery

“…Michael Vandenheuvel, 1  Korneel Vandewiele, 2 Filip De Somer 2 and Patrick F Wouters 1,3 To the Editor:…”

“…In this regard, our group has recently been investigating a novel promising Sonoclot-based parameter to estimate low-range heparin activity. 3 All these considerations should be taken into account to further optimize protamine dosage, which after over sixty years of daily use still proves to be a real conundrum. The brands of the drugs used can have important consequences.…”

“…In this regard, our group has recently been investigating a novel promising Sonoclot-based parameter to estimate low-range heparin activity. 3…”