Control of Heparin Therapy With Activated Partial Thromboplastin Times

I, Spector; Corn, Milton

doi:10.1001/jama.1967.03130030027006

Cited by 51 publications

(14 citation statements)

References 7 publications

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“…18,000 f 9,000 23,000 f 6,000 2 1,000 f 8,000 22,000 f 6,000 6. 8 10,000 -- Vol. 59 f 7000 U/day of heparin, 87.2% of APTT or 96.5% of AcCT and 97.1% of APTT or 100% of AcCT were respectively within or shorter than the therapeutic range; while respectively 50.0% or 100% in patients of Group A treated by mean dose of 19,000 f 4000 U/day of heparin and 55.5% or 77.8% in Group B treated by mean dose of 17,000 f 8000 U/day of heparin were longer than the therapeutic range.…”

Section: Aptt and Acct In Patients Treated With Heparinmentioning

confidence: 99%

Tissue factor activity in leukemia cells. Special reference to disseminated intravascular coagulation

Andoh

Kubota

Takada

et al. 1987

Cancer

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Tissue factor activity (TFA) of 10(8) leukemia cells was measured in 82 patients with acute nonlymphoid leukemia by the clotting method. The TFA bore a significant correlation to the development of disseminated intravascular coagulation (DIC) in these cases. Mean TFA value with standard deviation (SD) was 8.3 +/- 6.3 U in 48 cases with DIC, which was significantly higher than 0.3 +/- 4.2 U in 34 cases without DIC. Whereas Mean TFA in non-M3 was 0.9 +/- 6.3 U which was significantly lower than 37.2 +/- 2.3 U in M3, some non-M3 showed TFA as high as M3 and were complicated by DIC. In heparin treatment, dosage of heparin could not be controlled by either APTT or AcCT but was controlled by the extent of TFA of leukemia cells. Retrospective analysis of clinical features revealed that 97000X + 9000 units/day (X = logarithm value of TFA) of heparin is an adequate dosage for the successful treatment of DIC when TFA of leukemia cells is 0.8 U or more.

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Section: Aptt and Acct In Patients Treated With Heparinmentioning

confidence: 99%

Tissue factor activity in leukemia cells. Special reference to disseminated intravascular coagulation

Andoh

Kubota

Takada

et al. 1987

Cancer

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“…There was a strong relationship to the published halflife of LMWH [2,4,5,9]. In addition to the routine TEG ® measurements performed at 37°C, blood samples were incubated at different temperature levels in vitro (33-41°C).…”

Section: Discussionmentioning

confidence: 99%

“…LMWH's clinical efficacy is usually monitored by assessment of anti-Xa activity routinely measured at 37°C [9]. The method used is not temperature adjustable.…”

Section: Introductionmentioning

confidence: 99%

Hypothermia and hyperthermia decrease the anticoagulant potency of low molecular weight heparin measured with thrombelastgraphy

et al. 2006

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Zusammenfassung. Grundlagen: Das antikoagulatorische Potential von niedrig molekularem Heparin (Low Molecular Weight Heparin -LMWH) ist ausreichend nachgewiesen. Ziel unserer Studie war es, den Einfluss von Hypo-und Hyperthermie auf die LMWH-Antikoagulation abzuschätzen.Methodik: Es wurde Blut von 10 gesunden Freiwilligen vor und nach subkutaner Gabe von 5000 I.E. LMWH (Dalteparin) untersucht. Citrat-Blut, mit und ohne Heparinase, welches vor und während des Messvorganges in verschiedene Temperaturniveaus gebracht wurde, wurde mit dem Thomboelastographen untersucht.Ergebnisse: Vor der Verabreichung des LMWH war die Reaktionszeit r (18 ± 5,4 mm bei 37°C) im Normalbereich. Die Reaktionszeit verlängerte sich bei 37° Celsius nach LMWH-Gabe auf 35 mm. Bei hypothermen (28 mm bei 33°C und 33 mm bei 35°C) und hyperthermen Bedingungen (21 mm bei 38°C, 20 mm bei 41°C) war die Reaktionszeit verringert. Ähnliche Ergebnisse zeigen sich auch bei der Clot Formation Time, die bei 37°C noch 24 mm aufweist und bei 33°C und 35°C 19 bzw. 22 mm misst. Bei 38°C ist die Clot Formation Time mit 21 ebenfalls kürzer wie auch bei 41°C mit 20 mm (P < 0,05).Schlussfolgerungen: Die Ergebnisse zeigen eine signifikante Reduktion des mittels TEG gemessenen antikoagulatorischen Effekts. Diese Ergebnisse könnten für den klinischen Alltag von großer Bedeutung sein.Schlüsselwörter: Blut, Antikoagulanzien, Low Molecular Weight Heparin, Thrombelastographie, Temperatureffekt.Summary. Background: It is a fact that anticoagulant potency of low molecular weight heparin (LMWH) is well established under normothermic conditions. The aim of our study was to evaluate the effect of hypo-and hyperthermia on LMWH anticoagulation as measured by thrombelastography.Methods: Blood from 10 healthy volunteers was investigated before and after subcutaneous administration of 5000 IE of LMWH (dalteparin). Thrombelastography was performed with recalcified citrated whole blood with and without heparinase incubation at different test temperatures.Results: Mean ± SD reaction time was within the normal range before LMWH administration (18 ± 5.4 mm at 37°C). LMWH prolonged reaction time to 35 mm at 37°C, but non-normothermic test temperatures significantly decreased reaction time to 28 mm at 33°C, to 33 mm at 35°C, to 21 mm at 38°C, and to 20 mm at 41°C. Similarly, clot formation time was decreased from 24 mm at 37°C to 19 mm at 33°C, to 22 mm at 35°C, to 21 mm at 38°C, and to 20 mm at 41°C (P < 0.05).Conclusions: These results show that both hypo-and hyperthermic conditions significantly decreased the anticoagulant potency of LMWH when assessed by TEG ® analysis. These findings may be of clinical relevance in non-normothermic patients.

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“…If a patient is treated with heparin during the first few days of oral anticoagulant therapy the effect of circulating heparin is demonstrated by prolongation in the partial thromboplastin clotting-time (Eastham, 1962). In fact, the partial thromboplastin clotting-time is a better test than the whole-blood clotting-time for the control of heparin therapy (Spector and Corn, 1967).…”

Section: Discussionmentioning

confidence: 99%

Improved control of long-term anticoagulant therapy.

Eastham¹

1968

BMJ

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Control of Heparin Therapy With Activated Partial Thromboplastin Times

Abstract: In vitro and in vivo studies were carried out to determine whether a standardized laboratory procedure, the activated (kaolin) partial thromboplastin time (PTT), could be used to regulate heparin therapy. In

Cited by 51 publications

References 7 publications

Tissue factor activity in leukemia cells. Special reference to disseminated intravascular coagulation

Tissue factor activity in leukemia cells. Special reference to disseminated intravascular coagulation

Hypothermia and hyperthermia decrease the anticoagulant potency of low molecular weight heparin measured with thrombelastgraphy

Improved control of long-term anticoagulant therapy.

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