Anti-Factor-Xa and Activated Partial Thromboplastin Time Concordance and Outcomes in Adults Undergoing Extracorporeal Membrane Oxygenation: A Secondary Analysis of the Pilot Low-Dose Heparin in Critically Ill Patients Undergoing Extracorporeal Membrane Oxygenation Randomized Trial.
activated partial thromboplastin time
anti-factor-Xa
anticoagulation
extracorporeal membrane oxygenation
heparin resistance
Journal
Critical care explorations
ISSN: 2639-8028
Titre abrégé: Crit Care Explor
Pays: United States
ID NLM: 101746347
Informations de publication
Date de publication:
Nov 2023
Nov 2023
Historique:
medline:
13
11
2023
pubmed:
13
11
2023
entrez:
13
11
2023
Statut:
epublish
Résumé
To determine the concordance between activated partial thromboplastin time (aPTT) and anti-factor-Xa (anti-Xa) in adults undergoing extracorporeal membrane oxygenation (ECMO) and to identify the factors associated with discordant paired aPTT/anti-Xa. Pre-planned secondary analysis of the Low-Dose Heparin in Critically Ill Patients Undergoing Extracorporeal Membrane Oxygenation pilot randomized unblinded, parallel-group controlled trial. Two ICUs in two university hospitals. Thirty-two critically ill patients who underwent ECMO and who had at least one paired aPTT and anti-Xa assay performed at the same time. We analyzed the concordance between aPTT and anti-Xa and identified factors associated with discordant paired aPTT/anti-Xa based on their respective therapeutic ranges. We also compared biological parameters between heparin resistance episode and no heparin resistance. Of the 32 patients who were included in this study, 24 (75%) had at least one discordant paired aPTT/anti-Xa. Of the 581 paired aPTT/anti-Xa that were analyzed, 202 were discordant. The aPTT was relatively lower than anti-Xa in 66 cases (32.7%) or relatively higher than anti-Xa in 136 cases (67.3%). Thirty-three heparin resistance episodes were identified in six patients (19%). In these critically ill patients undergoing ECMO, one third of paired aPTT/anti-Xa measures was discordant. Coagulopathy and heparin resistance might be the reasons for discordance. Our results support the potential importance of routinely monitoring both tests in this setting.
Identifiants
pubmed: 37954899
doi: 10.1097/CCE.0000000000000999
pmc: PMC10635598
doi:
Types de publication
Journal Article
Langues
eng
Pagination
e0999Informations de copyright
Copyright © 2023 The Authors. Published by Wolters Kluwer Health, Inc. on behalf of the Society of Critical Care Medicine.
Références
Crit Care Med. 2019 Jul;47(7):e563-e571
pubmed: 31033512
J Thromb Thrombolysis. 2016 Jan;41(1):165-86
pubmed: 26780745
Crit Care. 2020 Jul 13;24(1):427
pubmed: 32660540
Anesthesiology. 2020 Mar;132(3):562-570
pubmed: 31764152
Pediatr Crit Care Med. 2014 Feb;15(2):e72-9
pubmed: 24335992
Front Med (Lausanne). 2018 Dec 12;5:352
pubmed: 30619862
ASAIO J. 2020 Mar;66(3):300-306
pubmed: 31045921
Crit Care Med. 2023 May 1;51(5):e115-e121
pubmed: 36853326
Clin Appl Thromb Hemost. 2018 Mar;24(2):310-316
pubmed: 29212374
ASAIO J. 2018 Sep/Oct;64(5):623-629
pubmed: 29076942
Intensive Care Med. 2022 Aug;48(8):1076-1079
pubmed: 35689697
Ann Pharmacother. 2021 May;55(5):592-604
pubmed: 32959678
N Engl J Med. 2021 Aug 26;385(9):826-832
pubmed: 34437785
Crit Care. 2020 Jan 20;24(1):19
pubmed: 31959232
Transfus Med Rev. 2015 Apr;29(2):90-101
pubmed: 25595476
J Clin Neurol. 2015 Oct;11(4):383-9
pubmed: 26320848
Arch Intern Med. 1994 Jan 10;154(1):49-56
pubmed: 8267489
Thromb Res. 2019 Mar;175:53-58
pubmed: 30708169
Pediatr Crit Care Med. 2014 May;15(4):e175-82
pubmed: 24622165
Ann Intensive Care. 2016 Dec;6(1):97
pubmed: 27714705
Pharmacotherapy. 2012 Jun;32(6):546-58
pubmed: 22531940
J Intensive Care Med. 2020 Jul;35(7):679-686
pubmed: 29768983
Intensive Care Med. 1996 Jul;22(7):707-10
pubmed: 8844239
Ann Intensive Care. 2018 Jan 16;8(1):7
pubmed: 29340875
Ann Pharmacother. 2013 Feb;47(2):151-8
pubmed: 23386070