OBJECTIVE: To assess the utility of activated clotting time, activated partial thromboplastin time, and anti-Factor Xa assay for the monitoring and dosing of heparin in pediatric patients requiring support with extracorporeal membrane oxygenation. DESIGN: Retrospective chart review. SETTING: PICU in a single, tertiary care, academic children's hospital. PATIENTS: Seventeen patients (age 1 d to 13.9 yr, median 0.83 yr) managed on pulmonary and cardiac extracorporeal membrane oxygenation between March 2010 and August 2012 by a single surgeon. INTERVENTIONS: None. MEASUREMENTS AND MAIN RESULTS: Twice daily measurements of anti-Factor Xa assay, activated clotting time, and activated partial thromboplastin time were determined from the same blood specimen. Data were analyzed using SAS system v9.2. Fourteen patients (82.4%) were successfully weaned from extracorporeal membrane oxygenation and 12 (70.6%) were discharged from the hospital. Pearson correlations were used to compare heparin dose and activated clotting time, activated partial thromboplastin time, and anti-Factor Xa assay. Analysis showed negative Pearson correlations in 11 of 17 patients between the activated clotting time and heparin, as compared with seven of 17 for activated partial thromboplastin time and only one for heparin and anti-Factor Xa assay. Only four patients had moderate to strong positive correlations between activated clotting time and heparin as compared with a moderate to strong positive correlation in 10 patients for anti-Factor Xa assay and heparin. CONCLUSIONS: The anti-Factor Xa assay correlated better with heparin dosing than activated clotting time or activated partial thromboplastin time. Activated clotting time has a poor correlation to heparin doses commonly associated with extracorporeal membrane oxygenation. In pediatric extracorporeal membrane oxygenation, anti-Factor Xa assay may be a more valuable monitor of heparin administration.
OBJECTIVE: To assess the utility of activated clotting time, activated partial thromboplastin time, and anti-Factor Xa assay for the monitoring and dosing of heparin in pediatric patients requiring support with extracorporeal membrane oxygenation. DESIGN: Retrospective chart review. SETTING: PICU in a single, tertiary care, academic children's hospital. PATIENTS: Seventeen patients (age 1 d to 13.9 yr, median 0.83 yr) managed on pulmonary and cardiac extracorporeal membrane oxygenation between March 2010 and August 2012 by a single surgeon. INTERVENTIONS: None. MEASUREMENTS AND MAIN RESULTS: Twice daily measurements of anti-Factor Xa assay, activated clotting time, and activated partial thromboplastin time were determined from the same blood specimen. Data were analyzed using SAS system v9.2. Fourteen patients (82.4%) were successfully weaned from extracorporeal membrane oxygenation and 12 (70.6%) were discharged from the hospital. Pearson correlations were used to compare heparin dose and activated clotting time, activated partial thromboplastin time, and anti-Factor Xa assay. Analysis showed negative Pearson correlations in 11 of 17 patients between the activated clotting time and heparin, as compared with seven of 17 for activated partial thromboplastin time and only one for heparin and anti-Factor Xa assay. Only four patients had moderate to strong positive correlations between activated clotting time and heparin as compared with a moderate to strong positive correlation in 10 patients for anti-Factor Xa assay and heparin. CONCLUSIONS: The anti-Factor Xa assay correlated better with heparin dosing than activated clotting time or activated partial thromboplastin time. Activated clotting time has a poor correlation to heparin doses commonly associated with extracorporeal membrane oxygenation. In pediatric extracorporeal membrane oxygenation, anti-Factor Xa assay may be a more valuable monitor of heparin administration.
Authors: David C Chu; Abdel Ghanie Abu-Samra; Grayson L Baird; Cynthia Devers; Joseph Sweeney; Mitchell M Levy; Christopher S Muratore; Corey E Ventetuolo Journal: Intensive Care Med Date: 2014-12-03 Impact factor: 17.440
Authors: Junxin Wang; Fang Chen; Santiago J Arconada-Alvarez; James Hartanto; Li-Peng Yap; Ryan Park; Fang Wang; Ivetta Vorobyova; Grant Dagliyan; Peter S Conti; Jesse V Jokerst Journal: Nano Lett Date: 2016-09-28 Impact factor: 11.189
Authors: Ellen Colman; Ellen B Yin; Greg Laine; Subhasis Chatterjee; Siavosh Saatee; J Patrick Herlihy; Meredith A Reyes; Arthur W Bracey Journal: J Thorac Dis Date: 2019-08 Impact factor: 2.895
Authors: Tung Phi Nguyen; Xuan Thi Phan; Dai Quang Huynh; Ha Thi Viet Truong; Yen Nguyen Hai Le; Tuan Manh Nguyen; Quan Quoc Minh Du; Thao Phuong Le; Hai Ngoc Truong; Thi Thi Ho; Thao Thi Ngoc Pham Journal: Crit Care Res Pract Date: 2021-05-03
Authors: John C Lin; Lauren M Barron; Adam M Vogel; Ryan M Colvin; Sirine A Baltagi; Allan Doctor; Avihu Z Gazit; Mary Mehegan; Nicole O'Connor; Ahmed S Said; Mark Shepard; Michael Wallendorf; Philip C Spinella Journal: Front Cardiovasc Med Date: 2021-06-10