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Measuring Activated Clotting Time during Cardiac Catheterization and PCI: The Effect of the Sampling Site
Journal of Interventional Cardiology ( IF 2.1 ) Pub Date : 2021-09-13 , DOI: 10.1155/2021/4091289
J C Heemelaar 1 , T Berkhout 1 , A A C M Heestermans 1 , J C Zant 2 , A M J de Vos 3 , N J W Verouden 4 , M T Dirksen 1 , J van Ramshorst 1
Affiliation  

Background/Purpose. We aimed to investigate the influence of the sampling site on the variability of ACT measurement. Activated clotting time (ACT) has been used for decades in cardiac surgery and interventional cardiology to assess unfractionated heparin activity. However, standardized protocols for the use of ACT measurement in the catheterization laboratory are lacking. Methods/Materials. After elective cardiac catheterization, ACT measurements were collected in simultaneously obtained blood samples from three different sample sites: the arterial catheter, arterial sheath, and peripheral intravenous line. Measurements were performed using the i-Stat® device (Abbott, Princeton, NJ, USA). The study was conducted with approval of the local medical ethical committee. Results. In 100 patients (mean age 67.1, 65% male), no significant differences were observed in ACT values obtained from the guiding catheter and arterial sheath (mean difference (MD) −18.3 s; standard deviation (SD) 96 s; ). Contrarily, ACT values obtained from the intravenous line were significantly lower as compared to values obtained from the guiding catheter (MD 25.7 s; SD 75.5; ) and arterial sheath (MD 39 s; SD 102.8; ). Furthermore, ACT measurements from the arterial sheath showed a statistically significant proportional bias when compared to the other sampling sites (sheath vs. catheter, r = 0.761, ; sheath vs. IVL, r = 1.013, ). Conclusions. The present study shows statistical significance and possibly clinically relevant variations between ACT measurements from different sample sites. Bias in ACT measurements may be minimized by using uniform protocols for ACT measurement during cardiac catheterization.

中文翻译:

测量心导管插入术和 PCI 期间的活化凝血时间:采样点的影响

背景/目的。我们旨在调查采样点对 ACT 测量变异性的影响。几十年来,活化凝血时间 (ACT) 已在心脏手术和介入心脏病学中用于评估普通肝素活性。然而,缺乏在导管插入实验室中使用 ACT 测量的标准化协议。方法/材料。在选择性心导管插入术后,从三个不同的样本部位同时获得的血液样本中收集 ACT 测量值:动脉导管、动脉鞘和外周静脉导管。使用 i-Stat® 设备(Abbott,Princeton,NJ,USA)进行测量。该研究是在当地医学伦理委员会的批准下进行的。结果. 在 100 名患者(平均年龄 67.1 岁,65% 男性)中,从引导导管和动脉鞘获得的 ACT 值未观察到显着差异(平均差 (MD) -18.3 秒;标准差 (SD) 96 秒;)。相反,从静脉导管获得的 ACT 值显着低于从引导导管获得的值(MD 25.7 s;SD 75.5;)和动脉鞘 (MD 39 s; SD 102.8;)。此外,与其他采样点(鞘与导管, r  = 0.761,; 鞘与IVL, r  = 1.013,)。 结论。本研究显示了来自不同样本位点的 ACT 测量值之间的统计学意义和可能的临床相关变化。通过在心导管插入术期间使用统一的 ACT 测量协议,可以最大限度地减少 ACT 测量的偏差。
更新日期:2021-09-13
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