SCCM Resource Library-Anti-Xa Monitoring for UFH: Benefits and Pitfalls

Video Transcription

Video Summary

The video transcript discusses the advantages and pitfalls of anti-10A monitoring for unfractionated heparin (UFH). It explains that UFH has been used for over 100 years, and monitoring of heparin has always been important in optimizing patient outcomes. The two most common labs used for monitoring heparin are activated partial thromboplastin time (APTT) and anti-10A assay. The anti-10A assay is a more direct measure of heparin activity, with reproducible values across institutions. It has several advantages over APTT, including improved time to therapeutic anticoagulation, fewer dose adjustments, and reduced oscillations between non-therapeutic values. Discordance between APTT and anti-10A is common, with disagreement rates ranging from 40% to 60%. However, anti-10A monitoring is complicated by the presence of factor 10A inhibitors, Fondaparinux, and low molecular weight heparins. Cost and processing time are factors to consider before implementing anti-10A monitoring. Despite the disadvantages, the transcript concludes that anti-10A monitoring should be widely adopted due to its clinical benefits.

Asset Subtitle

Pharmacology, Quality and Patient Safety, 2022

Asset Caption

Anticoagulation strategies and monitoring vary by institution. Laboratory monitoring protocols and applications in a variety of situations, including extracorporeal membrane oxygenation, will be reviewed. Quality assurance for this high-risk medication with continuous evaluation of protocols and areas of practice improvement will be highlighted though clinical cases.

Meta Tag

Content Type Presentation

Knowledge Area Pharmacology

Knowledge Area Quality and Patient Safety

Knowledge Level Advanced

Membership Level Select

Tag Anticoagulation

Tag Quality and Patient Safety

Year 2022

Keywords

anti-10A monitoring

unfractionated heparin

activated partial thromboplastin time

heparin activity

therapeutic anticoagulation

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