摘要
AIM To assess utility and correlation of known anticoagulation parameters in the management of pediatric ventricular assist device(VAD).METHODS Retrospective study of pediatric patients supported with a Berlin EXCOR VAD at a single pediatric tertiary care center during a single year.RESULTS We demonstrated associations between activated thro-mboplastin time(a PTT)and R-thromboelastography(R-TEG)values(rs=0.65,P<0.001)and between anti-Xa assay and R-TEG values(rs=0.54,P<0.001).The strongest correlation was seen between a PTT and anti-Xa assays(rs=0.71,P<0.001).There was also a statistically significant correlation between platelet counts and the maximum amplitude of TEG(rs=0.71,P<0.001).Importantly,there was no association between dose of unfractionated heparin and either measure of anticoagulation(a PTT,anti-Xa or R-TEG value).CONCLUSION This study suggests that while there is strong correlation between a PTT,anti-Xa assay and R-TEG values for patients requiring VAD support,there is a lack of relevant correlation between heparin dose and degree of effect.This raises concern as various guidelines continue to recommend using these parameters to titrate heparin therapy.
作者简介
Correspondence to:Shriprasad R Deshpande,MBBS,MS,Division of Pediatric Cardiology,Emory University School of Medicine,Children’s Healthcare of Atlanta,1405,Clifton Rd NE,Atlanta,GA 30322,United States.deshpandes@kidsheart.com Telephone:+1-404-6947739 Fax:+1-770-4889480
