Thomason T, Riegel B, Jessen D, Smith S C, Gocka I, Rich M
Intensive Care/Progressive Care Units, Sharp Cabrillo Hospital, San Diego, CA 92110.
Am J Crit Care. 1993 Jan;2(1):81-7.
To evaluate the clinical safety of heparin titration and the procedural cost of anticoagulation measurement using bedside low-range activated clotting time.
Quasi-experimental study using data gathered through retrospective record review.
Coronary care, medical intensive care and telemetry units of a community hospital.
Sample of 102 patients undergoing elective percutaneous transluminal coronary angioplasty.
Intravenous heparin therapy was titrated using low-range activated clotting time in 51 percutaneous transluminal coronary angioplasty patients. Data from this group were compared to a matched sample of 51 angioplasty patients whose intravenous heparin therapy was titrated using activated partial thromboplastin time.
No differences in procedural, early or late complications were found between the groups. The cost of managing heparin therapy with low-range activated clotting time was less than with activated partial thromboplastin time.
These results suggest that titrating heparin therapy based on bedside low-range activated clotting time for the angioplasty patients in this sample was as safe as with activated partial thromboplastin time. Use of bedside low-range activated clotting time saved money for the hospital.
评估肝素滴定的临床安全性以及使用床旁低范围活化凝血时间进行抗凝测量的程序成本。
采用回顾性记录审查收集的数据进行的准实验研究。
一家社区医院的冠心病监护病房、医学重症监护病房和遥测病房。
102例行择期经皮冠状动脉腔内血管成形术患者的样本。
对51例行经皮冠状动脉腔内血管成形术的患者使用低范围活化凝血时间滴定静脉肝素治疗。将该组数据与51例使用活化部分凝血活酶时间滴定静脉肝素治疗的血管成形术患者的匹配样本进行比较。
两组在手术、早期或晚期并发症方面未发现差异。使用低范围活化凝血时间管理肝素治疗的成本低于使用活化部分凝血活酶时间。
这些结果表明，在此样本中，对血管成形术患者基于床旁低范围活化凝血时间滴定肝素治疗与使用活化部分凝血活酶时间一样安全。使用床旁低范围活化凝血时间为医院节省了费用。
