Clinical safety and cost of heparin titration using bedside activated clotting time.
OBJECTIVE
To evaluate the clinical safety of heparin titration and the procedural cost of anticoagulation measurement using bedside low-range activated clotting time.


METHODS
Quasi-experimental study using data gathered through retrospective record review.


METHODS
Coronary care, medical intensive care and telemetry units of a community hospital.


METHODS
Sample of 102 patients undergoing elective percutaneous transluminal coronary angioplasty.


METHODS
Intravenous heparin therapy was titrated using low-range activated clotting time in 51 percutaneous transluminal coronary angioplasty patients. Data from this group were compared to a matched sample of 51 angioplasty patients whose intravenous heparin therapy was titrated using activated partial thromboplastin time.


RESULTS
No differences in procedural, early or late complications were found between the groups. The cost of managing heparin therapy with low-range activated clotting time was less than with activated partial thromboplastin time.


CONCLUSIONS
These results suggest that titrating heparin therapy based on bedside low-range activated clotting time for the angioplasty patients in this sample was as safe as with activated partial thromboplastin time. Use of bedside low-range activated clotting time saved money for the hospital.
Thomason
T
T
Intensive Care/Progressive Care Units, Sharp Cabrillo Hospital, San Diego, CA 92110.
Riegel
B
B
Jessen
D
D
Smith
S C
SC
Gocka
I
I
Rich
M
M
D015906:Angioplasty, Balloon, Coronary; D015400:Clinical Nursing Research; D003327:Coronary Disease / Q000097:blood / Q000451:nursing / Q000628:therapy*; D003362:Cost-Benefit Analysis; D016903:Drug Monitoring / Q000191:economics* / Q000379:methods* / Q000451:nursing; D005249:Fees and Charges; D006470:Hemorrhage / Q000139:chemically induced / Q000453:epidemiology; D006493:Heparin / Q000008:administration & dosage / Q000009:adverse effects / Q000627:therapeutic use*; D006801:Humans; D015994:Incidence; D007262:Infusions, Intravenous; D007362:Intensive Care Units; D016555:Matched-Pair Analysis; D010314:Partial Thromboplastin Time; D012189:Retrospective Studies; D014914:Whole Blood Coagulation Time; D016526:Workload / Q000191:economics
D006493:Heparin