SCCM Resource Library-Case-Based Integration: Discordant aPTT Versus Anti-Xa Values

Video Transcription

Video Summary

In this video, the speaker discusses the issue of discrepancies between APTT (Activated Partial Thromboplastin Time) and anti-10A (anti-10 factor) values in monitoring and dosing unfractionated heparin for patients in the ICU. Two patient cases are presented to illustrate the challenges posed by these discordant values. Several factors can contribute to these discrepancies, including concomitant systemic anticoagulation, antiphospholipid antibodies, factor deficiencies, liver disease, acute phase reactants, and triglyceride levels in critically ill patients. It is important to correctly interpret these values and consider the individual patient's risk of bleeding and clot extension when making decisions about anticoagulation therapy. While both APTT and anti-10A assays have their strengths and weaknesses, they can be used in a complementary manner in complex hospitalized patients. It is crucial to monitor and adjust heparin therapy carefully and to consider the reasons for abnormal values in order to optimize patient outcomes.

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 Pharmacokinetics Pharmacodynamics

Tag Quality and Patient Safety

Year 2022

Keywords

discrepancies

APT

anti-10A

unfractionated heparin

ICU

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