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

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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 by polybrene 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.