Monitoring Heparin Therapy in Hemodialysis

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Abstract
Three tests of anticoagulation—the activated partial thromboplastin time (aPTT) and the Celite and BaSon activated whole blood coagulation times—were evaluated to determine the value of each test as a reliable monitor of heparin sodium therapy in mongrel dogs, normal human controls, and patients with renal failure undergoing hemodialysis. Mean normal clotting times were as follows: aPTT, 29.42 seconds; Celite, 92.54 seconds; and BaSon, 80.40 seconds. The Celite and BaSon test values increased essentially as a linear function of rising heparin concentration, while the aPPT values rapidly became inaccurate. Therapeutic ranges in each test reflecting adequate heparinization were as follows: aPPT, 60 to 100 seconds; Celite, 140 to 200 seconds, and BaSon, 160 to 300 seconds. The Celite and BaSon tests are rapid, accurate, simple monitors of heparin-induced anticoagulation levels, and they are particularly useful to control anticoagulation in patients undergoing hemodialysis.