title: Activated partial thromboplastin times from venipuncture versus central venous catheter specimens in adults receiving continuous heparin infusions.
abstract: BACKGROUND
  In patients receiving heparin infusions, variations in specimen collection technique may contribute to inaccurate measurements of activated partial thromboplastin time (aPTT).
  
  
  OBJECTIVE
  To determine if there is a difference in aPTT results between specimens collected from a central venous access device (CVAD) compared with venipuncture in patients receiving heparin infusions.
  
  
  METHODS
  Simultaneous blood samples (CVAD vs venipuncture) from 66 patients receiving continuous heparin infusions were compared.
  
  
  RESULTS
  The mean aPTT difference (peripheral aPTT minus CVAD aPTT) was -7.3 seconds (P=.07). Neither length of time heparin was turned off (P=.18) nor waste volume (P=.32) was significantly associated with the difference in aPTT. The median aPTT difference when the CVAD specimen was obtained from the heparin infusion port was -20.5 seconds, compared with -0.1, -3.0, and -0.2 seconds for specimens from a port proximal to, distal to, or coterminal with the heparin infusion, respectively (P=.008).
  
  
  CONCLUSIONS
  Use of this protocol resulted in similar aPTTs when the CVAD specimen was not obtained from the heparin infusion port. However, obtaining the specimen from the heparin infusion port resulted in significantly higher aPTT values.
authors.affiliation: Mary Sue Dailey is a clinical nurse specialist at Advocate Good Samaritan Hospital in Downers Grove, Illinois.Barbara Berger is a faculty member at the University of Illinois at Chicago College of Nursing and consults on evidence-based practice and clinical research.Fortunata Dabu is a nurse clinician at Advocate Good Samaritan Hospital. She is certified in medical-surgical nursing. mary-sue.dailey@advocatehealth.com.
authors.forename: Mary Sue
authors.initials: MS
authors.lastname: Dailey
authors.affiliation: Mary Sue Dailey is a clinical nurse specialist at Advocate Good Samaritan Hospital in Downers Grove, Illinois.Barbara Berger is a faculty member at the University of Illinois at Chicago College of Nursing and consults on evidence-based practice and clinical research.Fortunata Dabu is a nurse clinician at Advocate Good Samaritan Hospital. She is certified in medical-surgical nursing.
authors.forename: Barbara
authors.initials: B
authors.lastname: Berger
authors.affiliation: Mary Sue Dailey is a clinical nurse specialist at Advocate Good Samaritan Hospital in Downers Grove, Illinois.Barbara Berger is a faculty member at the University of Illinois at Chicago College of Nursing and consults on evidence-based practice and clinical research.Fortunata Dabu is a nurse clinician at Advocate Good Samaritan Hospital. She is certified in medical-surgical nursing.
authors.forename: Fortunata
authors.initials: F
authors.lastname: Dabu
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000925:Anticoagulants / Q000008:administration & dosage*; D001800:Blood Specimen Collection / Q000379:methods*; D002405:Catheterization, Central Venous; D005260:Female; D006493:Heparin / Q000008:administration & dosage*; D006801:Humans; D007262:Infusions, Intravenous; D008297:Male; D008875:Middle Aged; D010314:Partial Thromboplastin Time; D018962:Phlebotomy / Q000379:methods*
chemical_list: D000925:Anticoagulants; D006493:Heparin