Effect of Subcutaneous Unfractionated Heparin Prophylaxis on Activated Partial Thromboplastin Time: A Retrospective Evaluation
Abstract Study Objective Characterize the incidence of elevated aPTT results in patients treated with prophylactic, subcutaneous unfractionated heparin (UFH). Design Retrospective, cohort analysis. Setting Single-center, university hospital. Measurements Evaluation of 257 patients with activated par...
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| Veröffentlicht in: | Journal of clinical anesthesia 2016-09, Vol.33, p.346-350 |
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| creator | Thompson, Molly H., PharmD, BCPS Wilson, Sylvia H., MD Toussaint, Brittany L., PharmD, BCPS Jordan, Cameron L., PharmD, BCPS Hayes, Genevieve L., PharmD, MSPharm, BCPS McKinzie, Brian P., PharmD, BCPS, BCNSP Wolf, Bethany J., Ph.D Field, Larry C., MD |
| description | Abstract Study Objective Characterize the incidence of elevated aPTT results in patients treated with prophylactic, subcutaneous unfractionated heparin (UFH). Design Retrospective, cohort analysis. Setting Single-center, university hospital. Measurements Evaluation of 257 patients with activated partial thromboplastin time (aPTT) testing both prior to and following subcutaneous (SC) unfractionated heparin (UFH) therapy. Main Results Evaluated patients received UFH 5000 units every 8 hours. Baseline aPTT values were within the normal range (mean ± SD, 32.0 ± 8.5 seconds). After initiation of UFH, aPTT values increased (mean ± SD, 37.6 ± 15.2 seconds). After 24 hours of SC UFH, mean aPTT values (mean ± SD, 38.6 ± 15.5) exceeded the normal laboratory range (23.3–35.7 seconds). An elevated aPTT result after UFH was associated with baseline aPTT, length of therapy, and weight-based UFH dose. A significant association was not identified between aPTT elevation and age, race, sex, history of liver disease, type of admission, or transfusion of blood products. Conclusions Treatment with UFH resulted in a small, but significant, increase in aPTT. |
| doi_str_mv | 10.1016/j.jclinane.2015.11.020 |
| format | Article |
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Design Retrospective, cohort analysis. Setting Single-center, university hospital. Measurements Evaluation of 257 patients with activated partial thromboplastin time (aPTT) testing both prior to and following subcutaneous (SC) unfractionated heparin (UFH) therapy. Main Results Evaluated patients received UFH 5000 units every 8 hours. Baseline aPTT values were within the normal range (mean ± SD, 32.0 ± 8.5 seconds). After initiation of UFH, aPTT values increased (mean ± SD, 37.6 ± 15.2 seconds). After 24 hours of SC UFH, mean aPTT values (mean ± SD, 38.6 ± 15.5) exceeded the normal laboratory range (23.3–35.7 seconds). An elevated aPTT result after UFH was associated with baseline aPTT, length of therapy, and weight-based UFH dose. A significant association was not identified between aPTT elevation and age, race, sex, history of liver disease, type of admission, or transfusion of blood products. Conclusions Treatment with UFH resulted in a small, but significant, increase in aPTT.</description><identifier>ISSN: 0952-8180</identifier><identifier>EISSN: 1873-4529</identifier><identifier>DOI: 10.1016/j.jclinane.2015.11.020</identifier><identifier>PMID: 27555191</identifier><language>eng</language><publisher>United States: Elsevier Inc</publisher><subject>Activated partial thromboplastin time ; Adult ; Age ; Age Factors ; Aged ; Anesthesia & Perioperative Care ; Anticoagulants ; Anticoagulants - adverse effects ; Anticoagulants - therapeutic use ; Blood products ; Blood Transfusion ; Body mass index ; Cohort Studies ; Ethnic Groups ; Female ; Heparin - adverse effects ; Heparin - therapeutic use ; Humans ; Injections, Subcutaneous ; Intraoperative Complications - prevention & control ; Laboratories ; Liver Diseases - blood ; Male ; Middle Aged ; Multivariate analysis ; Pain Medicine ; Partial Thromboplastin Time ; Patients ; Retrospective Studies ; Sex Characteristics ; Thoracic surgery ; Unfractionated heparin ; Venous Thromboembolism - prevention & control ; Venous thromboembolism prophylaxis</subject><ispartof>Journal of clinical anesthesia, 2016-09, Vol.33, p.346-350</ispartof><rights>Elsevier Inc.</rights><rights>2016 Elsevier Inc.</rights><rights>Copyright © 2016 Elsevier Inc. All rights reserved.</rights><rights>Copyright Elsevier Limited Sep 2016</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c587t-c56e23e5ad52cfb439596eb9d08798ed9616a45c83dc190de1e42e11729da5e53</citedby><cites>FETCH-LOGICAL-c587t-c56e23e5ad52cfb439596eb9d08798ed9616a45c83dc190de1e42e11729da5e53</cites><orcidid>0000-0002-5259-7879 ; 0000-0003-1401-5628 ; 0000-0003-0524-2503 ; 0000-0002-8975-5375</orcidid></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktohtml>$$Uhttps://www.sciencedirect.com/science/article/pii/S0952818016301349$$EHTML$$P50$$Gelsevier$$H</linktohtml><link.rule.ids>230,314,776,780,881,3537,27901,27902,65306</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/27555191$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Thompson, Molly H., PharmD, BCPS</creatorcontrib><creatorcontrib>Wilson, Sylvia H., MD</creatorcontrib><creatorcontrib>Toussaint, Brittany L., PharmD, BCPS</creatorcontrib><creatorcontrib>Jordan, Cameron L., PharmD, BCPS</creatorcontrib><creatorcontrib>Hayes, Genevieve L., PharmD, MSPharm, BCPS</creatorcontrib><creatorcontrib>McKinzie, Brian P., PharmD, BCPS, BCNSP</creatorcontrib><creatorcontrib>Wolf, Bethany J., Ph.D</creatorcontrib><creatorcontrib>Field, Larry C., MD</creatorcontrib><title>Effect of Subcutaneous Unfractionated Heparin Prophylaxis on Activated Partial Thromboplastin Time: A Retrospective Evaluation</title><title>Journal of clinical anesthesia</title><addtitle>J Clin Anesth</addtitle><description>Abstract Study Objective Characterize the incidence of elevated aPTT results in patients treated with prophylactic, subcutaneous unfractionated heparin (UFH). Design Retrospective, cohort analysis. Setting Single-center, university hospital. Measurements Evaluation of 257 patients with activated partial thromboplastin time (aPTT) testing both prior to and following subcutaneous (SC) unfractionated heparin (UFH) therapy. Main Results Evaluated patients received UFH 5000 units every 8 hours. Baseline aPTT values were within the normal range (mean ± SD, 32.0 ± 8.5 seconds). After initiation of UFH, aPTT values increased (mean ± SD, 37.6 ± 15.2 seconds). After 24 hours of SC UFH, mean aPTT values (mean ± SD, 38.6 ± 15.5) exceeded the normal laboratory range (23.3–35.7 seconds). An elevated aPTT result after UFH was associated with baseline aPTT, length of therapy, and weight-based UFH dose. A significant association was not identified between aPTT elevation and age, race, sex, history of liver disease, type of admission, or transfusion of blood products. Conclusions Treatment with UFH resulted in a small, but significant, increase in aPTT.</description><subject>Activated partial thromboplastin time</subject><subject>Adult</subject><subject>Age</subject><subject>Age Factors</subject><subject>Aged</subject><subject>Anesthesia & Perioperative Care</subject><subject>Anticoagulants</subject><subject>Anticoagulants - adverse effects</subject><subject>Anticoagulants - therapeutic use</subject><subject>Blood products</subject><subject>Blood Transfusion</subject><subject>Body mass index</subject><subject>Cohort Studies</subject><subject>Ethnic Groups</subject><subject>Female</subject><subject>Heparin - adverse effects</subject><subject>Heparin - therapeutic use</subject><subject>Humans</subject><subject>Injections, Subcutaneous</subject><subject>Intraoperative Complications - prevention & control</subject><subject>Laboratories</subject><subject>Liver Diseases - blood</subject><subject>Male</subject><subject>Middle Aged</subject><subject>Multivariate analysis</subject><subject>Pain Medicine</subject><subject>Partial Thromboplastin Time</subject><subject>Patients</subject><subject>Retrospective Studies</subject><subject>Sex Characteristics</subject><subject>Thoracic surgery</subject><subject>Unfractionated heparin</subject><subject>Venous Thromboembolism - prevention & control</subject><subject>Venous thromboembolism prophylaxis</subject><issn>0952-8180</issn><issn>1873-4529</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2016</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><sourceid>8G5</sourceid><sourceid>BENPR</sourceid><sourceid>GUQSH</sourceid><sourceid>M2O</sourceid><recordid>eNqNksFu1DAQhiMEotvCK1SWuHDZxWPHScyhYlUtFKkSFd2eLa8zYR2SONjJqnvh2euwbYFeQJbsw3zzj2fmT5JToAugkL2rF7VpbKc7XDAKYgGwoIw-S2ZQ5HyeCiafJzMqBZsXUNCj5DiEmlIaA_AyOWK5EAIkzJKfq6pCMxBXketxY8YhKroxkJuu8toM1nV6wJJcYK-97ciVd_123-hbG4jryDISu1_AlfaD1Q1Zb71rN65vdBgiv7YtvidL8hUH70KPE49ktdPNqCfxV8mLSjcBX9-_J8nNx9X6_GJ--eXT5_Pl5dyIIh_inSHjKHQpmKk2KZdCZriRJS1yWWApM8h0KkzBSwOSlgiYMgTImSy1QMFPkrODbj9uWiwNdoPXjeq9bbXfK6et-jvS2a365nZK5EWaZ3kUeHsv4N2PEcOgWhsMNs1hXgoKHotlBc_-A4U0HiYm1TdP0NqNvouTmASBM5bnMlLZgTJxhsFj9fhvoGpyg6rVgxvU5AYFoKIbYuLpn10_pj2sPwIfDgDG2e8sehWMxc5gaX3clSqd_XeNsycSE2WNbr7jHsPvflRgiqrryZOTJSHjFHgq-R3WQODP</recordid><startdate>20160901</startdate><enddate>20160901</enddate><creator>Thompson, Molly H., PharmD, BCPS</creator><creator>Wilson, Sylvia H., MD</creator><creator>Toussaint, Brittany L., PharmD, BCPS</creator><creator>Jordan, Cameron L., PharmD, BCPS</creator><creator>Hayes, Genevieve L., PharmD, MSPharm, BCPS</creator><creator>McKinzie, Brian P., PharmD, BCPS, BCNSP</creator><creator>Wolf, Bethany J., Ph.D</creator><creator>Field, Larry C., MD</creator><general>Elsevier Inc</general><general>Elsevier Limited</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>3V.</scope><scope>7RV</scope><scope>7X7</scope><scope>7XB</scope><scope>88E</scope><scope>8FI</scope><scope>8FJ</scope><scope>8FK</scope><scope>8G5</scope><scope>ABUWG</scope><scope>AFKRA</scope><scope>AZQEC</scope><scope>BENPR</scope><scope>CCPQU</scope><scope>DWQXO</scope><scope>FYUFA</scope><scope>GHDGH</scope><scope>GNUQQ</scope><scope>GUQSH</scope><scope>K9.</scope><scope>KB0</scope><scope>M0S</scope><scope>M1P</scope><scope>M2O</scope><scope>MBDVC</scope><scope>NAPCQ</scope><scope>PQEST</scope><scope>PQQKQ</scope><scope>PQUKI</scope><scope>PRINS</scope><scope>Q9U</scope><scope>7X8</scope><scope>7QO</scope><scope>7U7</scope><scope>8FD</scope><scope>C1K</scope><scope>FR3</scope><scope>P64</scope><scope>5PM</scope><orcidid>https://orcid.org/0000-0002-5259-7879</orcidid><orcidid>https://orcid.org/0000-0003-1401-5628</orcidid><orcidid>https://orcid.org/0000-0003-0524-2503</orcidid><orcidid>https://orcid.org/0000-0002-8975-5375</orcidid></search><sort><creationdate>20160901</creationdate><title>Effect of Subcutaneous Unfractionated Heparin Prophylaxis on Activated Partial Thromboplastin Time: A Retrospective Evaluation</title><author>Thompson, Molly H., PharmD, BCPS ; Wilson, Sylvia H., MD ; Toussaint, Brittany L., PharmD, BCPS ; Jordan, Cameron L., PharmD, BCPS ; Hayes, Genevieve L., PharmD, MSPharm, BCPS ; McKinzie, Brian P., PharmD, BCPS, BCNSP ; Wolf, Bethany J., Ph.D ; Field, Larry C., MD</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c587t-c56e23e5ad52cfb439596eb9d08798ed9616a45c83dc190de1e42e11729da5e53</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2016</creationdate><topic>Activated partial thromboplastin time</topic><topic>Adult</topic><topic>Age</topic><topic>Age Factors</topic><topic>Aged</topic><topic>Anesthesia & Perioperative Care</topic><topic>Anticoagulants</topic><topic>Anticoagulants - adverse effects</topic><topic>Anticoagulants - therapeutic use</topic><topic>Blood products</topic><topic>Blood Transfusion</topic><topic>Body mass index</topic><topic>Cohort Studies</topic><topic>Ethnic Groups</topic><topic>Female</topic><topic>Heparin - adverse effects</topic><topic>Heparin - therapeutic use</topic><topic>Humans</topic><topic>Injections, Subcutaneous</topic><topic>Intraoperative Complications - prevention & control</topic><topic>Laboratories</topic><topic>Liver Diseases - blood</topic><topic>Male</topic><topic>Middle Aged</topic><topic>Multivariate analysis</topic><topic>Pain Medicine</topic><topic>Partial Thromboplastin Time</topic><topic>Patients</topic><topic>Retrospective Studies</topic><topic>Sex Characteristics</topic><topic>Thoracic surgery</topic><topic>Unfractionated heparin</topic><topic>Venous Thromboembolism - prevention & control</topic><topic>Venous thromboembolism prophylaxis</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Thompson, Molly H., PharmD, BCPS</creatorcontrib><creatorcontrib>Wilson, Sylvia H., MD</creatorcontrib><creatorcontrib>Toussaint, Brittany L., PharmD, BCPS</creatorcontrib><creatorcontrib>Jordan, Cameron L., PharmD, BCPS</creatorcontrib><creatorcontrib>Hayes, Genevieve L., PharmD, MSPharm, BCPS</creatorcontrib><creatorcontrib>McKinzie, Brian P., PharmD, BCPS, BCNSP</creatorcontrib><creatorcontrib>Wolf, Bethany J., Ph.D</creatorcontrib><creatorcontrib>Field, Larry C., MD</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>ProQuest Central (Corporate)</collection><collection>Nursing & Allied Health Database</collection><collection>Health & Medical Collection</collection><collection>ProQuest Central (purchase pre-March 2016)</collection><collection>Medical Database (Alumni Edition)</collection><collection>Hospital Premium Collection</collection><collection>Hospital Premium Collection (Alumni Edition)</collection><collection>ProQuest Central (Alumni) (purchase pre-March 2016)</collection><collection>Research Library (Alumni Edition)</collection><collection>ProQuest Central (Alumni Edition)</collection><collection>ProQuest Central UK/Ireland</collection><collection>ProQuest Central Essentials</collection><collection>ProQuest Central</collection><collection>ProQuest One Community College</collection><collection>ProQuest Central Korea</collection><collection>Health Research Premium Collection</collection><collection>Health Research Premium Collection (Alumni)</collection><collection>ProQuest Central Student</collection><collection>Research Library Prep</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>Nursing & Allied Health Database (Alumni Edition)</collection><collection>Health & Medical Collection (Alumni Edition)</collection><collection>Medical Database</collection><collection>Research Library</collection><collection>Research Library (Corporate)</collection><collection>Nursing & Allied Health Premium</collection><collection>ProQuest One Academic Eastern Edition (DO NOT USE)</collection><collection>ProQuest One Academic</collection><collection>ProQuest One Academic UKI Edition</collection><collection>ProQuest Central China</collection><collection>ProQuest Central Basic</collection><collection>MEDLINE - Academic</collection><collection>Biotechnology Research Abstracts</collection><collection>Toxicology Abstracts</collection><collection>Technology Research Database</collection><collection>Environmental Sciences and Pollution Management</collection><collection>Engineering Research Database</collection><collection>Biotechnology and BioEngineering Abstracts</collection><collection>PubMed Central (Full Participant titles)</collection><jtitle>Journal of clinical anesthesia</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Thompson, Molly H., PharmD, BCPS</au><au>Wilson, Sylvia H., MD</au><au>Toussaint, Brittany L., PharmD, BCPS</au><au>Jordan, Cameron L., PharmD, BCPS</au><au>Hayes, Genevieve L., PharmD, MSPharm, BCPS</au><au>McKinzie, Brian P., PharmD, BCPS, BCNSP</au><au>Wolf, Bethany J., Ph.D</au><au>Field, Larry C., MD</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Effect of Subcutaneous Unfractionated Heparin Prophylaxis on Activated Partial Thromboplastin Time: A Retrospective Evaluation</atitle><jtitle>Journal of clinical anesthesia</jtitle><addtitle>J Clin Anesth</addtitle><date>2016-09-01</date><risdate>2016</risdate><volume>33</volume><spage>346</spage><epage>350</epage><pages>346-350</pages><issn>0952-8180</issn><eissn>1873-4529</eissn><abstract>Abstract Study Objective Characterize the incidence of elevated aPTT results in patients treated with prophylactic, subcutaneous unfractionated heparin (UFH). Design Retrospective, cohort analysis. Setting Single-center, university hospital. Measurements Evaluation of 257 patients with activated partial thromboplastin time (aPTT) testing both prior to and following subcutaneous (SC) unfractionated heparin (UFH) therapy. Main Results Evaluated patients received UFH 5000 units every 8 hours. Baseline aPTT values were within the normal range (mean ± SD, 32.0 ± 8.5 seconds). After initiation of UFH, aPTT values increased (mean ± SD, 37.6 ± 15.2 seconds). After 24 hours of SC UFH, mean aPTT values (mean ± SD, 38.6 ± 15.5) exceeded the normal laboratory range (23.3–35.7 seconds). An elevated aPTT result after UFH was associated with baseline aPTT, length of therapy, and weight-based UFH dose. A significant association was not identified between aPTT elevation and age, race, sex, history of liver disease, type of admission, or transfusion of blood products. Conclusions Treatment with UFH resulted in a small, but significant, increase in aPTT.</abstract><cop>United States</cop><pub>Elsevier Inc</pub><pmid>27555191</pmid><doi>10.1016/j.jclinane.2015.11.020</doi><tpages>5</tpages><orcidid>https://orcid.org/0000-0002-5259-7879</orcidid><orcidid>https://orcid.org/0000-0003-1401-5628</orcidid><orcidid>https://orcid.org/0000-0003-0524-2503</orcidid><orcidid>https://orcid.org/0000-0002-8975-5375</orcidid><oa>free_for_read</oa></addata></record> |
| fulltext | fulltext |
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| ispartof | Journal of clinical anesthesia, 2016-09, Vol.33, p.346-350 |
| issn | 0952-8180 1873-4529 |
| language | eng |
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| source | MEDLINE; Elsevier ScienceDirect Journals |
| subjects | Activated partial thromboplastin time Adult Age Age Factors Aged Anesthesia & Perioperative Care Anticoagulants Anticoagulants - adverse effects Anticoagulants - therapeutic use Blood products Blood Transfusion Body mass index Cohort Studies Ethnic Groups Female Heparin - adverse effects Heparin - therapeutic use Humans Injections, Subcutaneous Intraoperative Complications - prevention & control Laboratories Liver Diseases - blood Male Middle Aged Multivariate analysis Pain Medicine Partial Thromboplastin Time Patients Retrospective Studies Sex Characteristics Thoracic surgery Unfractionated heparin Venous Thromboembolism - prevention & control Venous thromboembolism prophylaxis |
| title | Effect of Subcutaneous Unfractionated Heparin Prophylaxis on Activated Partial Thromboplastin Time: A Retrospective Evaluation |
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