The Journal of extra-corporeal technology
-
J Extra Corpor Technol · Mar 2003
Comparative StudyMaintaining adequate anticoagulation on extracorporeal membrane oxygenation therapy: Hemochron Junior Low Range versus Hemochron 400.
Extracorporeal membrane oxygenation (ECMO) therapy requires that patients be anticoagulated to prevent clotting and thrombotic complications. There are several bedside whole blood microcoagulation systems available to determine activated clotting time (ACT) levels. Many ECMO centers use Hemochron (International Technidyne, Edison, NJ) products to determine ACT levels. ⋯ There is a difference in the ACT values produced by Hemochron 400 and Hemochron Jr. LR. Failure to calibrate target ACT levels after changing machines may lead to shorter circuit life and more clotting complications.
-
J Extra Corpor Technol · Dec 2002
Review Comparative StudyCoronary artery bypass grafting: an off-pump versus on-pump review.
There has been a proliferation in the number of coronary artery bypass grafts (CABG) being performed without the use of cardiopulmonary bypass (CPB). However, the benefits of off-pump coronary artery grafting (OPCAB) are still being determined. The aim of this retrospective review was to compare the perioperative outcomes of CPB patients with OPCAB patients and to identify the patients most likely to benefit from the off-pump procedure. ⋯ Differences between either operation groups in transfusion rates were only statistically significant for the one to three grafted patients, while postoperative stays were similar for patients having four grafts. These results suggest that OPCAB is associated with a reduction in mortality and morbidity, particularly within the higher-risk patients. However, the benefits of OPCAB diminished with an increasing number of distal anastomoses performed.
-
J Extra Corpor Technol · Dec 2002
Case ReportsArgatroban in adult extracorporeal membrane oxygenation.
This case report addresses the use of Argatroban, an anticoagulant and thrombin inhibitor for treatment of thrombocytopenia in an adult patient on extracorporeal membrane oxygenation (ECMO). After 5 days on ECMO, the patient showed signs of heparin-induced thrombocytopenia (HIT) with a platelet count of 20K. ⋯ Given the occurrence of HIT with heparin therapy, a need for alternate drug therapy is required for patients requiring treatment with ECMO. The use of Argatroban in adult ECMO is outlined and includes dosage, monitoring, and patient treatment.
-
J Extra Corpor Technol · Sep 2002
Comparative StudyComparison of five point-of-care prothrombin and activated partial thromboplastin time devices based on age of blood sample.
Delays in processing statium (STAT) blood samples have led to the production of an increasing number of point-of-care tests. Product inserts recommend measuring blood samples immediately after procurement, suggesting that delays may invalidate the test results. We studied the effect of the age of blood samples on point-of-care (POC) prothrombin time (PT) and an activated partial thromboplastin time (aPTT) result. ⋯ One device (Hemochron 801) reported results with 10-min aged blood that were statistically different from fresh blood. None of the aPTT tests results from any device produced results with aged blood that were clinically different from fresh blood. This study suggests that, in the tests evaluated, blood samples that have aged 10 or 18 min will produce clinically relevant aPTT and PT results, respectively.
-
J Extra Corpor Technol · Sep 2002
Comparative StudyHow does the age of a blood sample affect it's activated clotting time? Comparison of eight different devices.
Monitoring activated clotting time (ACT) during extracorporeal procedures is virtually universal. The ACT test is usually performed immediately following blood collection. However, certain situations may occur that delay rapid measurement. ⋯ In the heparinized group, the Actalyke device produced results with 10 and 15 min aged blood that were significantly longer than fresh blood sample results (ACT < 60 s = 426 +/- 66, 10 min = 457 +/- 82, 15 min = 450 +/- 68 s, p < .05). No other device produced significant differences for either time period. Based on this limited sample population, it seems that accurate ACT may be performed on blood samples up to 15 min old in many devices.