Rapid quantitation of plasma heparin and antithrombin III levels for cardiopulmonary bypass monitoring, using fluorometric substrate assays

Plasma heparin and ATIII levels were determined using recently developed fluorometric substrate techniques on serial samples taken from 9 unselected patients undergoing open-heart surgery on cardiopulmonary bypass. The fluorometric assay for ATIII and established clotting and immunological methods s...

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Published inThrombosis and haemostasis Vol. 50; no. 3; p. 745
Main Authors Savidge, G F, Kesteven, P J, Al-Hasani, S F, O'Brien, P F
Format Journal Article
LanguageEnglish
Published Germany 31.10.1983
Subjects
Antithrombin III - analysis
Blood Coagulation Tests
Cardiopulmonary Bypass
Female
Fluorometry
Heparin - blood
Humans
Male
Monitoring, Physiologic
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Summary:Plasma heparin and ATIII levels were determined using recently developed fluorometric substrate techniques on serial samples taken from 9 unselected patients undergoing open-heart surgery on cardiopulmonary bypass. The fluorometric assay for ATIII and established clotting and immunological methods showed a highly significant correlation (p less than 0.001). Heparin recovery was reduced in all cases, and plasma levels (fluorometric assay) demonstrated poor correlation to Whole Blood Activated Clotting Time (Hemochron) estimations. ATIII levels were dramatically reduced during bypass, and in 3 cases reached levels below 0.08 iu/ml. Heparin reversal schedules based upon empirical dosage led to excessive protamine administration by a mean factor of 3.3, as assessed by in vitro neutralization of standardized heparin concentrations.
ISSN:0340-6245
DOI:10.1055/s-0038-1665300