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Measurement of whole blood factor Xa-activated clotting time during hemodialysis with low-molecular-weight heparin

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Abstract

Purpose

To determine whole blood factor Xa-activated clotting time (XaACT), a test for monitoring low-molecular-weight heparins (LMWHs).

Methods

Blood was obtained from six healthy volunteers. Dalteparin, a LMWH, was mixed with the blood to concentrations of 0,05 and 1.0IU·ml−1. XaACT, activated clotting time (ACT), and activated partial thromboplastin time (APTT) were measured at each dalteparin concentration. XaACT of blood from the outflow and inflow sides of the blood circuit in seven hemodialysis patients was measured before and after bolus administration of 1000 IU of dalteparin, followed by continuous infusion at a rate of 500IU·h−1.

Results

XaACT, ACT, and APTT in dalteparin-containing blood from volunteers were correlated with dalteparin concentration (y=312.8x+86.4;r 2=0.88;P<0.001,y=41.8x +113.5;r 2=0.83;P<0.001, andy=59.5x+38.8;r 2=0.80;P<0.001, respectively). The regression slope of XaACT was steeper than those of ACT and APTT (P<0.001). In hemodialysis patients, dalteparin increased XaACT on the outflow and inflow sides of the circuit (P<0.001,P<0.05, respectively).

Conclusion

The measurement of XaACT can be employed to monitor LMWHs in clinical settings.

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References

  1. Borm JJJ, Krediet R, Sturk A, ten Cate JW (1986) Heparin versus low molecular weight heparin K2165 in chronic hemodialysis patients: a randomized cross-over study. Haemostasis 16 [Suppl 2]: 59–68.

    PubMed  Google Scholar 

  2. Schrader J, Stibbe W, Armstrong VW, Kandt M, Muche R, Köstering H, Seidel D, Scheler F (1988) Comparison of low molecular weight heparin to standard heparin in hemodialysis/hemofiltration. Kidney Int 33:890–896

    PubMed  CAS  Google Scholar 

  3. Boneu B, Faruel-bille V, Pierrejean D, Gabaig AM (1991) Limitations of the chronometric assays to determine plasma antifactor Xa activity during low molecular weight heparin therapy. Nouv Rev Fr Hematol 33:287–291.

    PubMed  CAS  Google Scholar 

  4. Greiber S, Weber U, Galle J, Brämer P, Schollmeyer P (1997) Activated clotting time is not a sensitive parameter to monitor anticoagulation with low molecular weight heparin in hemodialysis. Nephron 76:15–19

    Article  PubMed  CAS  Google Scholar 

  5. Tew CJ, Lane DA, Thompson E, Ireland H, Curtis JR (1988) Relationship between ex vivo anti-proteinase (factor Xa and thrombin) assays and in vivo anticoagulant effect of very low molecular weight heparin, CY 222. Br J Haematol 70:335–340.

    PubMed  CAS  Google Scholar 

  6. Barrowcliffe TW, Curtis AD, Johnson EA, Thomas DP (1988) An international standard for low molecular weight heparin. Thomb Haemost 60:10–7

    Google Scholar 

  7. Naganuma S, Takahashi K, Kobayashi H, Maekawa S, Hoshino T, Era K, Ota K (1993) Bed-side monitoring of low-molecular-weight heparin and its neutralization by-protamine during hemodialysis (in Japanese with English abstract). Nihon Touseki Igakkai Zasshi (J Jpn Soc Dial Ther) 26:1403–1408

    Google Scholar 

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Authors and Affiliations

  1. Intensive Care Unit, Oita Medical University, 1-1 Idaigaoka, Hasama-machi, 879-55, Oita, Japan

    Masakazu Mori, Takaaki Kitano & Takayuki Noguchi

  2. Department of Anesthesiology, Oita Medical University, 1-1 Idaigaoka, Hasama-machi, 879-55, Oita, Japan

    Shigenori Yoshitake & Shunsuke Oda

Authors
  1. Masakazu Mori
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  2. Shigenori Yoshitake
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  3. Takaaki Kitano
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  4. Shunsuke Oda
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  5. Takayuki Noguchi
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Mori, M., Yoshitake, S., Kitano, T. et al. Measurement of whole blood factor Xa-activated clotting time during hemodialysis with low-molecular-weight heparin. J Anesth 12, 130–132 (1998). https://doi.org/10.1007/BF02480090

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  • DOI: https://doi.org/10.1007/BF02480090

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