Evaluation of the TAS coagulation analyzer for monitoring heparin effect in cardiac surgical patients

Gibbs, N. M.; Weightman, William M.; Thackray, N. M.; Michalopoulos, N.

doi:10.1016/s1053-0770(98)90097-0

Cited by 13 publications

(13 citation statements)

References 11 publications

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“…Reported correlations (r) between bedside and laboratory aPTT results vary from 0.73 to 0.95. 6,9,10,[16][17][18][19] High correlations, however, do not necessarily indicate a high level of agreement between instruments. 14 The mean bias in aPTT results between bedside and laboratory instruments varies from -8 seconds to +12 seconds.…”

Section: Discussionmentioning

confidence: 99%

Use of the Activated Partial Thromboplastin Time for Heparin Monitoring

et al. 2001

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The objectives of the present study were to evaluate the relationship between heparin concentration and activated partial thromboplastin time (aPTT) results, define a heparin concentration-derived therapeutic range for each aPTT instrument, compare aPTT- and heparin concentration-guided dosage adjustment decisions, and compare laboratory- and bedside aPTT-guided decisions. In phase 1, 102 blood samples were analyzed for bedside and laboratory aPTTs and heparin concentration (used to establish aPTT therapeutic range). In phase 2, 100 samples were analyzed in the same manner. Correlations for aPTT compared with heparin ranged from 0.36 to 0.82. Dosage adjustment decisions guided by the aPTT agreed with those based on heparin concentration 63% to 80% of the time. Laboratory and bedside aPTT dosage adjustment decisions agreed 59% to 68% of the time. The correlation of aPTT with heparin concentration and agreement between aPTT- and heparin-guided decisions vary with the aPTT instrument. Decisions guided by laboratory aPTT results often disagree with decisions guided by bedside aPTT results.

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Section: Discussionmentioning

confidence: 99%

Use of the Activated Partial Thromboplastin Time for Heparin Monitoring

et al. 2001

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“…However, citrated whole blood is added to human placenta-tissue factor, the resulting real TAS PT-seconds are higher than that on the display (7). Furthermore, the TAS-analyzer seems to underestimate the International Normalized Ratio (INR) (8). The measuring principle of the GEMPCL is optical, because sample native whole blood should be given to the test device within seconds after blood drawing (9).…”

Section: Cardiopulmonary Bypass Surgerymentioning

confidence: 99%

Point of Care: Diagnostics in Hemostasisthe Wrong Direction?

Stief

Fareed

2003

Clin Appl Thromb Hemost

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Point-of-care-testing (POCT) is performance of a laboratory assay outside the laboratory by nontrained personnel. The advantages of POCT are: more rapid medical decisions, avoidance of long sample transports, and small samples. The disadvantages of POCT are: no laboratory personnel, insufficient calibration, quality control and maintenance, poor documentation, high costs, difficult comparability POCT/central laboratory. Therefore, disposing of a 24-hour central laboratory, the POCT spectrum should be limited to the vital parameters: K+, Ca++, Na+, glucose, creatinine, blood gases, hemoglobin or hematocrit, NH3, lactate. POCT offers no advantages, if the hospital has a rapid transport system such as a pneumatic delivery to the central laboratory. The rapid diagnosis of the acute hemostasis state of a patient should be performed in the 24-hour central laboratory that is connected to all hospital wards via a good pneumatic delivery.

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“…A light source shines on the PIOPs which reflects the light onto a photodetector that records signals as a function time. HMT has been reported to be able to monitor heparin concentrations between 1 and 10 IU/mL [42,43]. Gibbs et al [42] have demonstrated that the CV was less for HMT values (7.3–14.2%) when compared to celite ACT and a good linearity between HMT values and heparin levels added to specimens.…”

Section: Introductionmentioning

confidence: 99%

“…HMT has been reported to be able to monitor heparin concentrations between 1 and 10 IU/mL [42,43]. Gibbs et al [42] have demonstrated that the CV was less for HMT values (7.3–14.2%) when compared to celite ACT and a good linearity between HMT values and heparin levels added to specimens. Also Wallok et al [43] in their in vitro analysis reported a significant (r 2 = 0.988) dose – response of HMT from 0.078 – 10 U/mL heparin and in vivo investigation reported results of HMT similar to those from ACT.…”

Section: Introductionmentioning

confidence: 99%

Point-of-Care Testing of Hemostasis in Cardiac Surgery

Prisco

Paniccia

2003

Thrombosis J

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An excessive perioperative blood loss, that requires transfusion of blood products, sometimes occurs in patients undergoing cardiopulmonary bypass for cardiac surgery. Blood loss and transfusion requirements in these patients may be reduced with a better control of heparin treatment and its reversal. Blood component administration in patients with excessive postcardiopulmonary bypass bleeding has been empiric for a long time due to turnaround times of laboratory coagulation tests. Devices are now available for rapid, point-of-care assessment of hemostasis alterations to allow an appropriate, targeted therapy. In particular, a quick evaluation of platelet and coagulation defects with new point-of-care devices can optimize the administration of pharmacological and transfusion-based therapy in patients with excessive bleeding after cardiopulmonary bypass.

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Evaluation of the TAS coagulation analyzer for monitoring heparin effect in cardiac surgical patients

Cited by 13 publications

References 11 publications

Use of the Activated Partial Thromboplastin Time for Heparin Monitoring

Use of the Activated Partial Thromboplastin Time for Heparin Monitoring

Point of Care: Diagnostics in Hemostasisthe Wrong Direction?

Point-of-Care Testing of Hemostasis in Cardiac Surgery

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