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A novel method for the direct determination of heparin concentration during cardiopulmonary bypass surgery
- Source :
- Clinical chemistry and laboratory medicine. 51(10)
- Publication Year :
- 2013
-
Abstract
- Background: Heparin is the standard drug for anticoagulation treatment and is used in many cardiac surgical interventions to prevent blood clotting. The anticoagulation status is controlled by various clotting tests. However, these tests depend on parameters like temperature, hemodilution etc. and are thus not applicable for a direct monitoring of the heparin concentration. The aim of this prospective study was to test a novel light scattering assay (LiSA) for the direct determination of heparin concentration during cardiopulmonary bypass (CPB) surgery and to compare the heparin concentrations with routinely determined activated clotting time (ACT). Methods: The patient group consisted of 50 patients undergoing coronary bypass surgery with CPB. The coagulation status was monitored by the measurement of ACT, which was performed approximately every 30 min during surgery. Parallel to each ACT measurement, the heparin concentration was measured by LiSA. Results: For 70% of the patients, ACT and heparin concentration measured by LiSA correlated reasonably over the entire time course of the intervention. For 30% of the patients, an insufficient correlation or even no correlation at all was observed. Conclusions: This study showed that LiSA enables the determination of intra-operative heparin levels. The lack of correlation between ACT and heparin concentration in a substantial group of patients shows that monitoring of heparin concentration is important. A more precise blood coagulation management, in particular, a precise administration of heparin and protamine, should be based on a combination of the measurement of heparin concentration and of ACT, but not on ACT alone.
- Subjects :
- Male
medicine.medical_specialty
Whole Blood Coagulation Time
Light
Clinical Biochemistry
Activated clotting time
Sensitivity and Specificity
law.invention
Bias
law
Internal medicine
medicine
Cardiopulmonary bypass
Humans
Scattering, Radiation
Prospective Studies
Aged
Cardiopulmonary Bypass
biology
medicine.diagnostic_test
business.industry
Heparin
Biochemistry (medical)
Extracorporeal circulation
Anticoagulants
General Medicine
Middle Aged
Protamine
Coagulation
Bypass surgery
Anesthesia
biology.protein
Cardiology
Biological Assay
Female
Drug Monitoring
business
medicine.drug
Subjects
Details
- ISSN :
- 14374331
- Volume :
- 51
- Issue :
- 10
- Database :
- OpenAIRE
- Journal :
- Clinical chemistry and laboratory medicine
- Accession number :
- edsair.doi.dedup.....e02a0e5d9cdd72a1a3b50e3a678ee7b9