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Thromb Haemost 1979; 42(04): 1276-1285
DOI: 10.1055/s-0038-1657022
Original Article
Schattauer GmbH Stuttgart

Thrombin Time Dilution Test: A Simple Method for the Control of Heparin Therapy[*]

Javier Pizzuto
The Hospital General and from the Hospital de Enfermedades del Tórax, Centro Médico, Nacional, Instituto Mexicano del Seguro Social, Mexico City, México
,
Sergio Garcìa-Méndez
The Hospital General and from the Hospital de Enfermedades del Tórax, Centro Médico, Nacional, Instituto Mexicano del Seguro Social, Mexico City, México
,
Marìa de-la-Paz Reyna
The Hospital General and from the Hospital de Enfermedades del Tórax, Centro Médico, Nacional, Instituto Mexicano del Seguro Social, Mexico City, México
,
Manuel R Morales
The Hospital General and from the Hospital de Enfermedades del Tórax, Centro Médico, Nacional, Instituto Mexicano del Seguro Social, Mexico City, México
,
Agustìn Avilés
The Hospital General and from the Hospital de Enfermedades del Tórax, Centro Médico, Nacional, Instituto Mexicano del Seguro Social, Mexico City, México
,
Beatrìz Zavala
The Hospital General and from the Hospital de Enfermedades del Tórax, Centro Médico, Nacional, Instituto Mexicano del Seguro Social, Mexico City, México
,
Carlos Gaos
The Hospital General and from the Hospital de Enfermedades del Tórax, Centro Médico, Nacional, Instituto Mexicano del Seguro Social, Mexico City, México
› Author Affiliations
Further Information

Publication History

Received May 1978

Accepted 11 June 1978

Publication Date:
23 August 2018 (online)

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Summary

A modification of the thrombin time test (TT), which permits quantitative measurement of plasma heparin activity during therapy is described. The prolonged TT of plasma containing heparin can be corrected by dilution with platelet-rich plasma (PRP). Clinical heparin activity is considered adequate when prolonged TT of the plasma can be corrected at dilutions of from 1:4 to 1:8 (±20%). In vitro studies of 30 PRP samples containing different amounts of heparin showed that 1:4 and 1:8 dilutions did not correct prolonged TT (P<0.05) in the presence of more than 0.2 and 0.3 U of heparin/ml respectively, indicating that the adequate dose of heparin should fall between those levels which show correction at these dilutions, using the diluted TT method.

Patients treated with 100 U of heparin/kg every 4 or 6 h were studied: 52 without previous coagulation defects and 22 with disseminated intravascular coagulation (DIC). The results in the first group showed adequate dosage in 29 cases, overdosage in 12 and underdosage in 11. Hemorrhage occurred in 5 of the overdosage group. In the DIC series, 4 with underdosage of heparin did not improve; in 13 of 18 with adequate dosage, both hemorrhage and coagulapathy disappeared, while the other 5, with more severe complications did not improve. Based on these findings, the diluted TT appears to be a useful test in the assessment of heparin therapy, even in patients with previous coagulation abnormalities.

*Presented in part at the Vlth International Congress of Hemostasis and Thrombosis, Philadelphia, Pa., June, 1977.


 

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