Why the study?
Does unfractionated heparin dose correlate with anticoagulation parameters (aPTT, anti-Xa, R-TEG) in pediatric patients supported with a Berlin EXCOR VAD?
Does unfractionated heparin dose correlate with anticoagulation parameters (aPTT, anti-Xa, R-TEG) in pediatric patients supported with a Berlin EXCOR VAD?
Standard anticoagulation parameters do not correlate with unfractionated heparin dose in pediatric VAD patients, raising concerns about current guidelines recommending their use for titration.
Answers are grounded in this paper and cite their sources.
Anticoagulation parameters may not reliably guide heparin dosing in pediatric VAD; leaves open validation of optimal monitoring.
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. Importantly, there was no association between dose of unfractionated heparin and either measure of anticoagulation (aPTT, anti-Xa or R-TEG value). CONCLUSION: This study suggests that while there is strong correlation between aPTT, 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.
No takes yet. Share an insight, caveat, or question.
Bhatia et al. (2017) studied this question.
Synapse has enriched 5 closely related papers on similar clinical questions. Consider them for comparative context: