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Clinical Use of the Heparin Nomogram

Clinical Use of the Heparin Nomogram Abstract To the Editor.— I would like to elaborate further on an issue that Cruickshank and colleagues1 briefly mention regarding the general use of their recently published heparin nomogram. There are at least eight different sources of thromboplastin and 14 different laboratory systems currently in use in North America for activated partial thromboplastin time (APTT) determination. The College of American Pathologists issues proficiency survey plasma samples to participating hospitals across the nation on a quarterly basis and determines the mean APTT and the standard deviation for each method employed by participating laboratories. In 1990, the APTT determined from a single specimen (H2-01) ranged from 30.9±0.9 to 46.8±1.8 seconds, depending on the method used.2At McMaster University, the site of Cruickshank's study, a highly sensitive thromboplastin reagent is used, and APTTs ranging from 60 to 85 seconds correlate with therapeutic heparin levels (0.2 to 0.4 U/mL). At our institution, plain References 1. Cruickshank MK, Levine MN, Hirsh J, Roberts R, Siguenza M. A standard heparin nomogram for the management of heparin therapy . Arch Intern Med. 1991;151:333-337.Crossref 2. College of American Pathologists. 1990 CAP Surveys, Set H2-A . Northbrook, III: College of American Pathologists; 1990:1-4. 3. Hyers TM, Hull RD, Weg JG. Antithrombotic therapy for venous thromboembolic disease . Chest. 1989;95 ( (suppl) ):37-51.Crossref http://www.deepdyve.com/assets/images/DeepDyve-Logo-lg.png Archives of Internal Medicine American Medical Association

Clinical Use of the Heparin Nomogram

Archives of Internal Medicine , Volume 151 (11) – Nov 1, 1991

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Publisher
American Medical Association
Copyright
Copyright © 1991 American Medical Association. All Rights Reserved.
ISSN
0003-9926
eISSN
1538-3679
DOI
10.1001/archinte.1991.00400110144033
Publisher site
See Article on Publisher Site

Abstract

Abstract To the Editor.— I would like to elaborate further on an issue that Cruickshank and colleagues1 briefly mention regarding the general use of their recently published heparin nomogram. There are at least eight different sources of thromboplastin and 14 different laboratory systems currently in use in North America for activated partial thromboplastin time (APTT) determination. The College of American Pathologists issues proficiency survey plasma samples to participating hospitals across the nation on a quarterly basis and determines the mean APTT and the standard deviation for each method employed by participating laboratories. In 1990, the APTT determined from a single specimen (H2-01) ranged from 30.9±0.9 to 46.8±1.8 seconds, depending on the method used.2At McMaster University, the site of Cruickshank's study, a highly sensitive thromboplastin reagent is used, and APTTs ranging from 60 to 85 seconds correlate with therapeutic heparin levels (0.2 to 0.4 U/mL). At our institution, plain References 1. Cruickshank MK, Levine MN, Hirsh J, Roberts R, Siguenza M. A standard heparin nomogram for the management of heparin therapy . Arch Intern Med. 1991;151:333-337.Crossref 2. College of American Pathologists. 1990 CAP Surveys, Set H2-A . Northbrook, III: College of American Pathologists; 1990:1-4. 3. Hyers TM, Hull RD, Weg JG. Antithrombotic therapy for venous thromboembolic disease . Chest. 1989;95 ( (suppl) ):37-51.Crossref

Journal

Archives of Internal MedicineAmerican Medical Association

Published: Nov 1, 1991

References