血色素ACT- lr和ACT+试验皿监测中低肝素浓度的性能：一项体外研究。

IF 2.3 4区医学 Q2 ANESTHESIOLOGY

Journal of cardiothoracic and vascular anesthesia Pub Date : 2025-02-01 DOI:10.1053/j.jvca.2024.12.001

Janne Moilanen MD , Marika Pada MD , Pasi Ohtonen MSc , Timo Kaakinen MD, PhD , Matti Pokela MD, PhD , Eeva-Riitta Savolainen MD, PhD , Tiina Erkinaro MD, PhD

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引用次数: 0

摘要

目的：据生产商介绍，haemchron ACT- lr比色管的肝素浓度范围为0 - 2.5 IU/mL，而ACT+试剂盒的最佳浓度范围为1 - 6 IU/mL。我们假设在低至中等肝素浓度下，ACT- lr比ACT+更可靠。设计：体外研究。环境：三级保健大学医院。参与者：20名健康成人志愿者。干预措施：供体血液样品加入未分离肝素，浓度分别为0、0.5、1.0、1.5、2.0和2.5 IU/mL。从每个浓度开始，每个测试盒使用3种不同的haemchron Signature Elite设备进行3次测量，总共进行720次ACT测试。采用Bland-Altman方法和类内相关系数对数据进行分析。测量和主要结果：所有360 ACT+测试都产生了结果。360例中，38例（11%）ACT-LR测试高于最高测量范围；其中，36例来自肝素浓度≥2.0 IU/mL的120例检测。所有ACT- lr和ACT+测量之间的偏差为52 (95% CI, 48-56) celite秒，一致性的限制范围很广。从类内相关系数来看，ACT+的信度优于或等于ACT- lr。结论：在0.5 IU/mL浓度下，ACT+与ACT- lr的性能相当，高于0.5 IU/mL时，ACT+优于ACT- lr，对进行特异性低量程检测的合理性提出质疑。然而，如果从一种测试切换到另一种测试，ACT- lr和ACT+测量之间需要考虑明显的偏差。

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Performance of Hemochron ACT-LR and ACT+ Test Cuvettes in Monitoring Low to Moderate Heparin Concentrations: An In Vitro Study

Objectives

According to the manufacturer, the Hemochron ACT-LR cuvette is designated for heparin concentrations of 0 to 2.5 IU/mL, while the optimal concentration range for the ACT+ cartridge is 1 to 6 IU/mL. We hypothesized that at low to moderate heparin concentrations, the ACT-LR is more reliable than the ACT+.

Design

An in vitro study.

Setting

A tertiary care university hospital.

Participants

Twenty healthy adult volunteers.

Interventions

Donor blood samples were spiked with unfractionated heparin to concentrations of 0, 0.5, 1.0, 1.5, 2.0, and 2.5 IU/mL. From each concentration, 3 measurements were made with each test cassette using 3 different Hemochron Signature Elite devices, for a total of 720 ACT tests. The Bland-Altman method and intraclass correlation coefficients were used to analyze the data.

Measurements and Main Results

All 360 ACT+ tests yielded a result. Of 360, 38 (11%) ACT-LR tests ran above the upper measurement range; of these, 36 were from the 120 measurements at heparin concentrations ≥2.0 IU/mL. The bias between all ACT-LR and ACT+ measurements was 52 (95% CI, 48-56) celite seconds, and the limits of agreement were wide. Based on the intraclass correlation coefficients, the reliability of ACT+ was better than or equal to that of ACT-LR.

Conclusions

The performance of ACT+ is equal to that of ACT-LR up to a concentration of 0.5 IU/mL, above which ACT+ is superior to ACT-LR, questioning the rationale for a specific low-range test. However, there is a significant bias between ACT-LR and ACT+ measurements that needs to be considered if switching from one test to the other.

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来源期刊

Journal of cardiothoracic and vascular anesthesia 医学-呼吸系统

CiteScore

4.80

自引率

17.90%

发文量

606

审稿时长

37 days

期刊介绍： The Journal of Cardiothoracic and Vascular Anesthesia is primarily aimed at anesthesiologists who deal with patients undergoing cardiac, thoracic or vascular surgical procedures. JCVA features a multidisciplinary approach, with contributions from cardiac, vascular and thoracic surgeons, cardiologists, and other related specialists. Emphasis is placed on rapid publication of clinically relevant material.