title: Measurement of the activated partial thromboplastin time from a capillary (fingerstick) sample of whole blood. A new method for monitoring heparin therapy.
abstract: The monitoring of heparin anticoagulation is fraught with difficulties because of the need for repetitive venipunctures and the vagaries of sample handling and processing. The authors evaluated a new aPTT monitoring system with the potential to eliminate many of these difficulties. The Ciba Corning Diagnostics 512 Coagulation Monitor (CCD monitor) is a hand-held portable instrument that can measure an aPTT from a fingerstick sample of capillary whole blood. Fingerstick aPTTs from 319 subjects (including controls and individuals on heparin and/or warfarin) were compared to venipuncture-derived standard laboratory plasma aPTTs using different aPTT reagents on conventional instruments. The correlation coefficients between fingerstick and standard aPTTs (0.79-0.83) were the same as the correlation coefficient between standard laboratory aPTTs using different reagents (0.79). When venipuncture-derived whole blood was compared to fingerstick samples on the new instrument, the correlation coefficient was excellent (0.93). A high degree of precision, as demonstrated by low coefficients of variations, was shown for within-day and between-day testing using the CCD monitor and normal controls. This capillary whole blood, aPTT system is the first to provide the clinician with a means of rapidly and reliably assessing the anticoagulant response to heparin therapy at the bedside, and its use may ultimately lead to more efficient and effective therapy overall.
authors.affiliation: Department of Medicine, University of Massachusetts Medical School, Worchester 01655.
authors.forename: J
authors.initials: J
authors.lastname: Ansell
authors.forename: C
authors.initials: C
authors.lastname: Tiarks
authors.forename: J
authors.initials: J
authors.lastname: Hirsh
authors.forename: W
authors.initials: W
authors.lastname: McGehee
authors.forename: D
authors.initials: D
authors.lastname: Adler
authors.forename: R
authors.initials: R
authors.lastname: Weibert
mesh_terms: D001780:Blood Coagulation Tests / Q000295:instrumentation / Q000379:methods* / Q000706:statistics & numerical data; D001800:Blood Specimen Collection; D002196:Capillaries; D005385:Fingers; D006400:Hematocrit; D006493:Heparin / Q000097:blood* / Q000627:therapeutic use; D006801:Humans; D010314:Partial Thromboplastin Time; D010976:Platelet Count; D011786:Quality Control; D012016:Reference Values
chemical_list: D006493:Heparin