Antifactor Xa Activity for the Management of Anticoagulation during Cardiac Surgery.
Thorac Cardiovasc Surg
; 64(6): 494-500, 2016 Sep.
Article
em En
| MEDLINE
| ID: mdl-26757210
ABSTRACT
Background In patients with autoimmune diseases associated with antiphospholipid antibodies, precise management of anticoagulation during extracorporeal circulation (ECC) is complicated. It was the aim of the present study to determine whether antifactor Xa (aXa) activity is useful in guiding heparin therapy during ECC. Methods In 15 patients undergoing cardiac surgery, anticoagulation with unfractionated heparin (UFH) and its reversal with protamine were guided using activated clotting time (ACT) (>400 second during ECC; ≤100 second for UFH reversal). For each ACT, the corresponding aXa activity levels were measured. Results A total of 144 blood samples were obtained. ACT and aXa activity were significantly correlated (r = 0.771, p< 0.0001, Spearman rank-order correlation). Using receiver operating characteristic curve (ROC) analyses, the cutoffvalues for aXa activity were 1.14 IU/mL (area under the ROC curve [AUC] 0.89; inaccuracy rate 9.4%) to predict ACT > 400 seconds and 0.55 IU/mL (AUC 0.85; inaccuracy rate 13.3%) for ACT ≤ 100 seconds. Conclusion AXa activity is strongly correlated with ACT, and therefore may be feasible for managing anticoagulation with UFH during ECC.
Texto completo:
1
Coleções:
01-internacional
Base de dados:
MEDLINE
Assunto principal:
Autoanticorpos
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Coagulação Sanguínea
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Heparina
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Protaminas
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Fator Xa
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Monitorização Intraoperatória
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Procedimentos Cirúrgicos Cardíacos
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Antagonistas de Heparina
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Anticoagulantes
Tipo de estudo:
Observational_studies
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Prognostic_studies
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Risk_factors_studies
Limite:
Aged
/
Female
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Humans
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Male
/
Middle aged
País/Região como assunto:
Europa
Idioma:
En
Revista:
Thorac Cardiovasc Surg
Ano de publicação:
2016
Tipo de documento:
Article
País de afiliação:
Alemanha