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Accurate coagulation studies from heparinized radial artery catheters
R A Gregersen1, S L Underhill, J C Detter
1Department of Physiological Nursing, University of Washington, Seattle 98195.
Heart & Lung : the Journal of Critical Care
|November 1, 1987
Summary
Accurate coagulation studies, like activated partial thromboplastin time (aPTTT), are feasible from heparinized arterial catheters after cardiac surgery. However, discard volumes are critical, and thrombin time results from these lines are unreliable.
Area of Science:
- Cardiovascular Surgery
- Hematology
- Clinical Pathology
Background:
- Indwelling arterial catheters are common in post-cardiac surgery patients.
- Heparinized lines can interfere with coagulation test accuracy.
- Accurate coagulation monitoring is crucial for patient management.
Purpose of the Study:
- To assess the reliability of coagulation studies from heparinized radial artery catheters.
- To determine appropriate discard volumes for accurate activated partial thromboplastin time (aPTTT) results.
- To evaluate the suitability of these lines for thrombin time assays.
Main Methods:
- Coagulation studies (aPTTT and thrombin time) were performed on samples from indwelling heparinized radial artery catheters in 28 post-cardiac surgery patients.
- Different discard volumes were tested to optimize sample accuracy.
- Comparison of results from arterial lines versus standard venous draws.
Main Results:
- Activated partial thromboplastin time (aPTTT) results were found to be reliable when a total discard volume of 5.1 ml (0.6 ml dwell volume + 4.5 ml discard) was used.
- Thrombin time assay results from heparinized arterial catheters were unpredictable and unreliable.
- Heparin contamination significantly impacted thrombin time results.
Conclusions:
- Activated partial thromboplastin time (aPTTT) testing is feasible and reliable using heparinized radial artery catheters post-cardiac surgery with adequate sample discard.
- Thrombin time assays should not be performed using samples from these heparinized arterial lines.
- Separate venous sampling is recommended for thrombin time analysis to ensure accurate results.