An evaluation of monitoring possibilities of argatroban using rotational thromboelastometry and activated partial thromboplastin time
摘要：
Background: Rotational thrombelastometry/thrombelastography with ROTEM ; and TEG ; is becoming available bedside in an increasing number of intensive care units, where many patients with heparin-induced thrombocytopenia (HIT) are treated. The study has been performed in an effort to find out whether ROTEM ; could be an alternative to activated partial thromboplastin time (aPTT) when argatroban is used for anticoagulation. Methods: Argatroban was added in vitro to a series of citrated whole-blood samples from 10 healthy volunteers to obtain whole-blood concentrations of 0, 0.125, 0.25, 0.5, 1.0, 2.0, 4.0 and 8.0mg/l. ROTEM ; and whole-blood aPTT analyses were performed at each argatroban concentration. Correlation analyses were performed using the Spearman correlation analysis. Results: There was a significant and strong correlation between argatroban concentrations and clotting time (CT in ROTEM ; analysis with INTEM) ( P <0.0001 and r =0.98). Also, the ROTEM ; time to maximum clot formation velocity (MAXV-t) appeared to have a very strong and highly significant correlation to argatroban concentrations ( P <0.0001 and r =0.95). When we studied the correlation between aPTT and CT, we found a highly significant and strong correlation between these two analyses ( P <0.0001 and r =0.97), especially so in the clinically relevant therapeutic range up to 100s aPTT prolongation for HIT patients. Conclusion: A significant and strong correlation was found between argatroban concentrations and several ROTEM ; parameters. Rotational thrombelastometry/thrombelastography has a potential role in increasing the safety of argatroban anticoagulation in critically ill patients.
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DOI：
10.1111/j.1399-6576.2009.02082.x
被引量：
年份：
2010
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