Monitoring Heparin Therapy in Hemodialysis

Three tests of anticoagulation—the activated partial thromboplastin time (aPTT) and the Celite and BaSon activated whole blood coagulation times—were evaluated to determine the value of each test as a reliable monitor of heparin sodium therapy in mongrel dogs, normal human controls, and patients with renal failure undergoing hemodialysis. Mean normal clotting times were as follows: aPTT, 29.42 seconds; Celite, 92.54 seconds; and BaSon, 80.40 seconds. The Celite and BaSon test values increased essentially as a linear function of rising heparin concentration, while the aPPT values rapidly became inaccurate. Therapeutic ranges in each test reflecting adequate heparinization were as follows: aPPT, 60 to 100 seconds; Celite, 140 to 200 seconds, and BaSon, 160 to 300 seconds. The Celite and BaSon tests are rapid, accurate, simple monitors of heparin-induced anticoagulation levels, and they are particularly useful to control anticoagulation in patients undergoing hemodialysis.