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DOI: 10.1055/s-0038-1654229
A Simple Technique for the Measurement of Plasma Heparin Concentration during Anticoagulant Therapy[*]
Publication History
Publication Date:
28 June 2018 (online)
Summary
Blood is incoagulable for several hours after therapeutic doses of intravenous heparin when tested by the glass clotting time (CT) or activated partialthromboplastin test (APTT). A simple modification of the APTT is described which allows the quantitative measurement of plasma heparin levels at any time during therapy. In principal the test plasma is diluted in normal plasma before assay, thereby reducing the heparin concentration to a range which can be measured by the APTT. The corresponding plasma heparin concentration is estimated by reference to a single standard curve which applies for concentrationsfrom 0.1 to 10 I.U./ml of plasma. Since all samples are diluted in normal plasma, storage of blood at 4° or even 37° for up to 48 h does not significantly alter the results. The assay is applied in the study of plasma heparin disappearance time and in the control of anticoagulant therapy forthromboembolic disease.
* This work was supported by Grant #HE 12148-02 from the National Heart Institute, NIH, Bethesda, Maryland 20014, USA. Dr. Marder is the recipient of Research Career Development Award :#1-K4-HE-22, 394-02, from the National Heart Institute.
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References
- 1 Bauer G. Clinical experiences of a surgeon in the use of heparin. Amer. J. Cardiol 14: 29 1964;
- 2 Blakely J. A. A rapid bedside method for the control of heparin therapy. Canad. med. Ass. J 99: 1072 1968;
- 3 Blombäck B, Blombäck M, Olsson P, William-Olsson G, Senning Å. Determination of heparin level of the blood. Some observations on heparin elimination and correlation between heparin level and clotting time after intravenous injection. Acta chir. scand Suppl 245: 259 1959;
- 4 Degnan T. J, Karasik S, Lenahan J. Laboratory control of heparin therapy with the activated partial thromboplastin time test. Curr. Ther. Res 11: 390 1969;
- 5 Deykin D. The use of heparin. New Engl. J. Med 280: 937 1969;
- 6 Edwards A. L. Statistical Methods for the Behavioral Sciences. 116 Rinehart and Company, Inc; New York: 1954
- 7 Eiber H. B, Danishefsky I. Fate of injected heparin. Trans. Amer. Soc. Artif. Internal Organs 04: 152 1958;
- 8 Griffith G. G, Boggs R. P. The clinical usage of heparin. Amer. J. Cardiol 14: 39 1964;
- 9 Jaques L. B, Charles A. F. The assay of heparin. Quart. J. Pharm. Pharmacol 14: 1 1941;
- 10 Jaques L. B, Monkhouse F. G, Stewart M. A method for the determination of heparin in blood. J. Physiol 109: 41 1949;
- 11 Kernohan R. J, Todd G. Heparin therapy in thromboembolic disease. Lancet I: 621 1966;
- 12 Margolius Jr. A, Jackson D. P, Ratnoff O. D. Circulating anticoagulants: A study of 40 cases and a review of the literature. Medicine 40: 145 1961;
- 13 Matchett M. O, Ingram G. IG. Partial thromboplastin time test with kaolin. J. clin. Path 18: 465 1965;
- 14 Merskey G, Johnson A. J, Kleiner G. J, Wohl H. The defibrination syndrome: Clinical features and laboratory diagnosis. Brit. J. Haemat 13: 528 1967;
- 15 Monkhouse F. G, Jaques L. B. An improved method for the extraction of heparin from blood. J. Lab. clin. Med 36: 782 1950;
- 16 Olsson P, Lagergren H, Ek S. The elimination from plasma of intravenous heparin. An experimental study on dogs and humans. Acta med. scand 173: 619 1963;
- 17 Shulman N. R, Marder V. J, Hiller M. C. A new method for measuring minimum in vivo concentrations of Factor VIII applied in distribution and survival studies and in detecting Factor VIII inhibitors. In: Brinkhous K. M. (Ed.), The Hemophilias. 29 University of North Carolina Press; Chapel Hill: 1964
- 18 Spector I, Corn M. Control of heparin therapy with activated partial thromboplastin times. J. Amer. med. Assoc 201: 75 1967;
- 19 Welt L. G. Clinical Disorders of Hydration and Acid-base Equilibrium. 16 Little, Brown and Company; Boston: 1955
- 20 Zucker S, Cathey M. H. Control of heparin therapy. Sensitivity of the activated partial thromboplastin time for monitoring the antithrombotic effects of heparin. J. Lab. clin. Med 73: 320 1969;