Sensitivity and Specificity of the Hemochron, Hemotec and APTT for the Detection of Low Concentrations of Heparin

Abstract

This study compared two bedside methods recommended for the detection of low concentrations of heparin and the activated partial thromboplastin time (APTT), with reference to a laboratory measure of heparin concentration. Patients undergoing cardiopulmonary bypass had blood drawn at four stages when low levels of heparin could be expected. At each stage four tests were performed: whole blood clotting time using a Hemochron analyser with a Saline-Rinsed test cartridge, whole blood clotting time using a Hemotec analyser with a High Range Heparinase test cartridge, APTT, and heparin concentration bypolybrene neutralization. Thirty patients were studied. The sensitivity of the Saline-Rinsed Hemochron, Hemotec High Range Heparinase, and APTT in detecting concentrations of heparin less than 1 U/ml was 38%, 40% and 97%, respectively, while specificities were 87%, 90%, and 30%, respectively. Neither the Saline Rinsed Hemochron, nor the Hemotec Heparinase cartridge reliably detected concentrations of heparin less than 1 U/ml.