An Overview of Heparin Monitoring with the Anti-Xa Assay

Dean, Christina L.

doi:10.1007/978-1-0716-3175-1_22

Cited by 6 publications

(2 citation statements)

References 53 publications

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“…Unfractionated heparin: optimizing laboratory monitoring and reducing unwanted interference in everyday hemostasis test practice When indicated, laboratory monitoring of UFH therapy is typically accomplished using either an activated partial thromboplastin time (APTT) or an anti factor Xa (anti Xa) assay. 3,9- 12 In either case, these assays are based on established ther apeutic intervals (therapeutic reference range [TRR]) to maintain patients within a safe ther apeutic UFH range, since too low a level of UFH poses a risk of VTE recurrence, and too high of bleeding. 3, 10 For the chromogenic anti Xa assay, the most common TRR used is 0.3-0.7 U/ml.…”

Section: Review Articlementioning

confidence: 99%

Unfractionated heparin: optimizing laboratory monitoring and reducing unwanted interference in everyday hemostasis test practice

Favaloro,

Pasalic,

Lippi

2024

Polish Archives of Internal Medicine

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Unfractionated heparin: monitoring vs interference 1 (most typically for selected biochemical assays or blood gas analysis) (TAbLE 1). Accordingly, UFH is fairly common in the hospital setting. Therefore, a chance that a patient's sample contains hepa rin is high in laboratory practice. In fact, UFH may be present in samples used for monitoring patients on UFH therapy, 2,3 but it may also un desirably interfere with many laboratory tests. 4 The aim of this manuscript is to review UFH from the perspective of optimizing laboratory testing. We will consider both monitoring of UFH therapy and methods to avoid unwanted inter ference in laboratory tests, or, if avoidance is not possible, methods to overcome such interference. Unfractionated heparin for patient treatment and mon-itoring UFH is a relatively common and inexpen sive drug widely used to treat patients with re cent thrombosis and / or to prevent thrombosis re currence. 2,5,6 UFH is typically given by parenteral

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Section: Review Articlementioning

confidence: 99%

Unfractionated heparin: optimizing laboratory monitoring and reducing unwanted interference in everyday hemostasis test practice

Favaloro,

Pasalic,

Lippi

2024

Polish Archives of Internal Medicine

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“…Some assays add AT into the reagent mixture. This, it is argued, may increase the anti‐Xa activity especially in patients with low AT levels like those on ECMO 18 . In one study using low molecular weight heparin (LMWH) in paediatric patients given L‐Aspariginase.…”

Section: Ecmo Anticoagulation With Ufhmentioning

confidence: 99%

Interpretation of coagulation laboratory tests for patients on ECMO

Davidson

2024

Int J Lab Hematology

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Extracorporeal membrane oxygenation (ECMO) is a type of circulatory life support for patients with severe lung failure. The use of ECMO has increased worldwide since the pandemic of H1N1 in 2009 and more recently SARS‐CoV‐2 in 2020 both of which caused severe respiratory failure. ECMO patients experience both increased risk of bleeding and thrombosis. This is due to the pathological insult that damages the lungs, the ECMO circuit, coagulopathy, inflammation and anticoagulation. ECMO presents unique demands on the coagulation laboratory both in tests required to manage the patients and result interpretation. This is a personal opinion of 20 years ECMO experience as a clinical scientist and a short current review of the literature. It will focus on the laboratory coagulation tests used to manage ECMO patients, including different anticoagulants used, testing frequency and interpretation of the results.

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