Document Detail

External quality assurance for heparin monitoring.
MedLine Citation:
PMID:  22941784     Owner:  NLM     Status:  In-Data-Review    
Although there is considerable debate regarding the usefulness of laboratory heparin monitoring, these test processes reflect a substantial portion of hemostasis laboratory activity. Accordingly, external quality assurance (EQA) remains an essential component of such testing, and ensures that laboratories provide the best available service for patient management. This report provides an overview of recent and past EQA related to heparin monitoring using data from the Royal College of Pathologists of Australasia Haematology Quality Assurance Program, and heparin-containing plasma samples with concentrations ranging from 0 to 1.4 U/mL. Laboratory tests evaluated comprised activated partial thromboplastin time (APTT), thrombin time (TT), fibrinogen, and anti-Xa assays. Results for APTT and TT testing were largely as expected, showing prolongation with increasing concentrations of heparin. Fibrinogen assays were generally unaffected by the presence of therapeutic heparin levels. Although cross-laboratory median values for the anti-Xa assay were close to target values, substantial interlaboratory variation in results, expressed as coefficient of variation (CV), was observed in all exercises conducted over an 8-year period (5 to 28% for low-molecular weight heparin [LMWH] and 19 to 37% for unfractionated heparin). Duplicate samples sent in consecutive surveys resulted in similar median values. The use of a survey-provided standard as assay calibrant improved CVs in earlier surveys, but not in the most recent survey.
Roslyn A Bonar; Emmanuel J Favaloro; Katherine Marsden
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Publication Detail:
Type:  Journal Article     Date:  2012-06-30
Journal Detail:
Title:  Seminars in thrombosis and hemostasis     Volume:  38     ISSN:  1098-9064     ISO Abbreviation:  Semin. Thromb. Hemost.     Publication Date:  2012 Sep 
Date Detail:
Created Date:  2012-09-03     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  0431155     Medline TA:  Semin Thromb Hemost     Country:  United States    
Other Details:
Languages:  eng     Pagination:  632-9     Citation Subset:  IM    
Copyright Information:
Thieme Medical Publishers 333 Seventh Avenue, New York, NY 10001, USA.
Royal College of Pathologists of Australasia Haematology Quality Assurance Program, Northmead, New South Wales, Australia.
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