Bedside monitoring of anti-coagulation under LDL apheresis by means of aPTT testing with a coagulation monitor.
Optimally adjusted anticoagulation under LDL apheresis is essential for successful treatment: Excessive anticoagulation exposes the outpatient to the risk of uncontrolled hemorrhage, insufficient anticoagulation may shorten the duration of utilization of the immune-adsorption columns. A new device (coagulation monitor 512, Ciba Corning) allows individual adaptation of dosage and timing of heparin application by modifying the standard schedule (5,000 IU intravenously before treatment, 2,000 IU/h continuously). APTT was measured before and after application of heparin and then at 30-min intervals both by the coagulation monitor and by conventional laboratory methods; the respective heparin concentration was determined in addition. The correlation coefficient between the heparin concentration and both the monitor-derived and the laboratory-derived aPTT was 0.811 and 0.590, respectively. An explanation for this finding might be that the monitor avoids the influences induced by subsequent collection and testing of samples associated with laboratory procedures.
Taborski
U
U
Department of Hemostaseology and Transfusion Medicine, Kerckhoff-Klinik, Bad Nauheim.
Köhler
T
T
Böker
C
C
Müller-Berghaus
G
G
D008078:Cholesterol, LDL / Q000097:blood*; D004305:Dose-Response Relationship, Drug; D004867:Equipment Design; D006493:Heparin / Q000008:administration & dosage* / Q000493:pharmacokinetics; D006801:Humans; D006937:Hypercholesterolemia / Q000097:blood / Q000628:therapy*; D008991:Monitoring, Physiologic / Q000295:instrumentation*; D010314:Partial Thromboplastin Time
D008078:Cholesterol, LDL; D006493:Heparin