Top

Canadian Journal of Anesthesia/Journal canadien d'anesthésie

Published in:

01-08-2019 | Heparin | Correspondence

Pseudo heparin resistance caused by elevated factor VIII in a critically ill patient

Authors: Ian Downie, MD, Zachary Liederman, MD, FRCPC, Kartiga Thiyagarajah, MD, Rita Selby, MBBS, FRCPC, MSc, Yulia Lin, MD, FRCPC, CTBS

Published in: Canadian Journal of Anesthesia/Journal canadien d'anesthésie | Issue 8/2019

Excerpt

To the Editor,

Table

APTT and anti-Xa assay values as well as factor VIII, fibrinogen, and antithrombin levels of the patient described

Postoperative day	Time	APTT* (23–30 sec)	Anti-Xa assay† (0.3–0.7 IU·mL⁻¹)	FVIII ‡ (> 0.50 IU·mL⁻¹)	Fibrinogen (> 1.70 g·L⁻¹)	Antithrombin (> 0.33 IU·mL⁻¹)
28	13:18	17.1	0.09	6.286	-	-
	15:57	34.4	0.73	6.517	-	-
	17:08	50.6	0.94	5.471	-	-
29	17:56	-	-	6.514	2.29	1.14
30	01:53	17.1	-	5.575	-	-
	20:53	-	-	-	2.11	-
33	07:22	64.0	1.22	6.199	-	-
34	18:18	44.3	0.71	6.572	-	-

The target APTT range during this time period was 70–90.9 sec. APTT = activated partial thromboplastin time; IU = international units

*APTT reagent – Dade Actin® FS on Sysmex CS 5100; †Anti-Xa assay – Innovance ® Heparin on Sysmex CS 5100; ‡One stage Factor VIII assay on Sysmex CS 5100

…

Levine MN, Hirsh J, Gent M, et al. A randomized trial comparing activated thromboplastin time with heparin assay in patients with acute venous thromboembolism requiring large daily doses of heparin. Arch Intern Med 1994; 154: 49-56.CrossRef

Olson JD, Arkin CF, Brandt JT, et al. College of American Pathologists Conference XXXI on laboratory monitoring of anticoagulant therapy: laboratory monitoring of unfractionated heparin therapy. Arch Pathol Lab Med 1998; 122: 282-98.

Marciniak E, Gockerman JP. Heparin-induced decrease in circulating antithrombin-III. Lancet 1977; 2: 581-4.CrossRefPubMed

Hirsh J, van Aken WG, Gallus AS, Dollery CT, Cade JF, Yung WL. Heparin kinetics in venous thrombosis and pulmonary embolism. Circulation 1976; 53: 691-5.CrossRefPubMed

Young E, Prins M, Levine M, Hirsh J. Heparin binding to plasma proteins, an important mechanism for heparin resistance. Thromb Haemost 1992; 67: 639-43.CrossRefPubMed

Title: Pseudo heparin resistance caused by elevated factor VIII in a critically ill patient
Authors: Ian Downie, MD
Zachary Liederman, MD, FRCPC
Kartiga Thiyagarajah, MD
Rita Selby, MBBS, FRCPC, MSc
Yulia Lin, MD, FRCPC, CTBS
Publication date: 01-08-2019
Publisher: Springer International Publishing
Keyword: Heparin
Published in: Canadian Journal of Anesthesia/Journal canadien d'anesthésie / Issue 8/2019
Print ISSN: 0832-610X
Electronic ISSN: 1496-8975
DOI: https://doi.org/10.1007/s12630-019-01391-y

At a glance: The ONWARDS insulin icodec trials

Springer Medicine

Pseudo heparin resistance caused by elevated factor VIII in a critically ill patient

Excerpt

At a glance: The ONWARDS insulin icodec trials

Springer Medicine

Excerpt

Please log in to get access to this content

Other articles of this Issue 8/2019

Evaluation of the Dams TuLip-i™: a new airway device for flexible bronchoscopic intubation

A systematic review of technology-based preoperative preparation interventions for child and parent anxiety

The Pediatric Procedural Sedation Handbook

Intraoperative glucose variability, but not average glucose concentration, may be a risk factor for acute kidney injury after cardiac surgery: a retrospective study

Effect of iloprost inhalation on postoperative outcome in high-risk cardiac surgical patients: a prospective randomized-controlled multicentre trial (ILOCARD)

Hospital cost associated with anemia in elective colorectal surgery: a historical cohort study