Management of lepirudin therapy for a patient with XXXX using the whole blood ecarin clot time and activated partial thromboplastin time.

@entity1 @entity262 @entity882 @entity1701
A patient with @entity1701 ( @entity1701 ) and a history of heparin-induced @entity882 required lepirudin therapy. The @entity1 had an abnormal baseline activated partial thromboplastin time (aPTT), complicating management of his therapy. We investigated whether an alternative monitoring system, using a dry reagent technology [ @entity262 ( @entity262 )], could be used to monitor the @entity1 's whole blood ecarin clot time (ECT) and aPTT. Baseline values for the ECT and aPTT were normal with this system. During a continuous infusion of lepirudin, the @entity1 's whole blood ECT was maintained between a desired range of 150-200 s for 73% of the time. Similarly, his whole blood aPTT was maintained between 60 and 80 s for 80% of the time. In contrast, the @entity1 's plasma-based aPTT by standard methods was consistently > 150 s. The @entity1 underwent surgical procedures without complications. To further investigate the finding that the patient's antibody did not affect the aPTT with this system, we performed the ECT and the aPTT assays on the @entity262 Analyzer with plasma samples from 10 @entity1 with @entity1701 and abnormal aPTTs. All 10 samples had plasma ECT values within the normal range. Four @entity1 had normalization of the aPTT, suggesting that a subset of @entity1 with @entity1701 may benefit from the @entity262 aPTT assay when monitoring heparin or other anticoagulation therapy.
