Nguyen Tung Phi, Phan Xuan Thi, Huynh Dai Quang, Viet Truong Ha Thi, Hai Le Yen Nguyen, Nguyen Tuan Manh, Minh Du Quan Quoc, Le Thao Phuong, Truong Hai Ngoc, Ho Thi Thi, Ngoc Pham Thao Thi
Department of Intensive Care, Ho Chi Minh City University of Medicine and Pharmacy, Ho Chi Minh City, Vietnam.
Intensive Care Unit, Vinmec International Hospital, Hanoi, Vietnam.
Crit Care Res Pract. 2021 May 3;2021:5579936. doi: 10.1155/2021/5579936. eCollection 2021.
During ECMO, anticoagulants, in particular, unfractionated heparin (UFH), are commonly used and monitored by laboratory tests, including ACT, APTT, and anti-Xa level.
A single-center retrospective observational study was conducted on adult patients undergoing ECMO between January 2019 and January 2020 at a tertiary hospital. The correlations between ACT, APTT, anti-Xa, antithrombin, and UFH dose were assessed.
129 sets of measurements from 37 patients were obtained including ACT, APTT, anti-Xa, antithrombin, and UFH dose measured simultaneously. 102 out of 129 sets of values were interpreted as antithrombin deficiencies. The correlation coefficient between APTT and anti-Xa; ACT and anti-Xa are 0.72 and 0.33, respectively, < 0.001. The patients with normal antithrombin levels exhibited a significant correlation between APTT and anti-Xa ( = 0.80, < 0.001). ACT, on the other hand, was poorly correlated with UFH dose, whether there is AT deficiency or not. Anti-Xa and APTT are only moderately correlated with UFH dose in the group without antithrombin deficiency, with correlation coefficients of 0.62 and 0.57, respectively, < 0.05.
APTT value is strongly correlated with anti-Xa value, particularly in patients with normal antithrombin levels. However, the ACT value was poorly correlated with anti-Xa and not with the UFH dose. In groups without antithrombin deficiency, APTT and anti-Xa values only moderately correlated with UFH dose.
在体外膜肺氧合（ECMO）期间，抗凝剂，尤其是普通肝素（UFH），通常被使用，并通过实验室检测进行监测，包括活化凝血时间（ACT）、活化部分凝血活酶时间（APTT）和抗Xa水平。
对2019年1月至2020年1月在一家三级医院接受ECMO治疗的成年患者进行了一项单中心回顾性观察研究。评估了ACT、APTT、抗Xa、抗凝血酶和UFH剂量之间的相关性。
从37例患者中获得了129组测量数据，包括同时测量的ACT、APTT、抗Xa、抗凝血酶和UFH剂量。129组值中有102组被解释为抗凝血酶缺乏。APTT与抗Xa之间的相关系数；ACT与抗Xa之间的相关系数分别为0.72和0.33，P<0.001。抗凝血酶水平正常的患者中，APTT与抗Xa之间存在显著相关性（r=0.80，P<0.001）。另一方面，无论是否存在抗凝血酶缺乏，ACT与UFH剂量的相关性都很差。在无抗凝血酶缺乏的组中，抗Xa和APTT与UFH剂量仅呈中度相关，相关系数分别为0.62和0.57，P<0.05。
APTT值与抗Xa值密切相关，尤其是在抗凝血酶水平正常的患者中。然而，ACT值与抗Xa的相关性较差，与UFH剂量无关。在无抗凝血酶缺乏的组中，APTT和抗Xa值与UFH剂量仅呈中度相关。
