Detection of undiagnosed coagulopathies using routine rapid heparin neutralization

Edward R. Burns, V. Lee, B. Wenz

Research output: Contribution to journalArticle

3 Citations (Scopus)

Abstract

OBJECTIVE: To determine the most frequent clinical causes of a prolonged activated partial thromboplastin time (APTT) result, and to determine whether a new heparin-removal device (the Hepchek, Pall Biomedical, Glen Cove, NY 11542) is capable of efficiently detecting the causes of these values. DESIGN: A combination of chart review and laboratory testing comparing the criterion standard-the heparin chromogenic substrate assay-with the Hepchek. Laboratory investigations were blinded and controlled. SETTING: Inpatient, acute-care hospital. PATIENTS: A total of 1,000 hospital patients with a variety of hemostatic disorders. MAIN OUTCOME MEASURE: The extent to which the Hepchek accurately identified the etiology of a prolonged APTT result. RESULTS: The APTT was prolonged in 25.2% of samples. The presence of heparin in the sample was confirmed by chromogenic assay or by using the Hepchek heparin-removal filter. The presence of heparin was confirmed in 12.8% of all samples and in more than 50% of all abnormal samples. The cause of the abnormal APTT was often unappreciated by the clinician. Bayesian analysis of the Hepchek's ability to diagnose heparin correctly as the cause of the abnormal APTT showed a sensitivity of 100% and specificity of 99.9%. CONCLUSION: Use of the Hepchek in the routine clinical laboratory is an efficient and rapid method of detecting heparin as a cause of isolated prolonged APTT results, and should reduce demands for unwarranted coagulation analyses and inappropriate treatment with blood products.

Original languageEnglish (US)
Pages (from-to)113-116
Number of pages4
JournalClinical Laboratory Science
Volume8
Issue number2
StatePublished - 1995

Fingerprint

Partial Thromboplastin Time
Thromboplastin
Heparin
Assays
Hemostatic Disorders
Clinical laboratories
Chromogenics
Device Removal
Chromogenic Compounds
Bayes Theorem
Hemostatics
Coagulation
Inpatients
Blood
Sensitivity and Specificity
Testing

Keywords

  • Activated partial thromboplastin time
  • Coagulation
  • Heparin

ASJC Scopus subject areas

  • Biochemistry, Genetics and Molecular Biology(all)

Cite this

Detection of undiagnosed coagulopathies using routine rapid heparin neutralization. / Burns, Edward R.; Lee, V.; Wenz, B.

In: Clinical Laboratory Science, Vol. 8, No. 2, 1995, p. 113-116.

Research output: Contribution to journalArticle

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