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Hypothermia and Anticoagulant Monitoring

Here is a question sent to Kim Kinney from a Clarian Pharm D:

I’ve got a great question and I hope you can help.  We are using more and more induced hypothermia for cardiac arrest, and will especially see this increase as our regionalization for MI program gets up to speed.  So if someone is cooled, and they go to cath lab for an intervention and the anesthetist needs to give heparin to get to a certain activated clotting time (ACT, a POC test in surgery), what do we do since the cooling affects the ACT? Further, I was told that for a PTT, we should call the lab and let them know to run it at a certain temp to match the patient. Thanks! Joanna

Kim and Joanna, I really don’t have an answer to this one, but I’m throwing it out here assuming someone is doing some research. Kim mentions that on most automated instruments there is no way to change the specimen or reaction temperature. The key question may not be how to run the assays, but to try to see empirically how heparin and other anticoagulants affect the patient in hypothermia. And further, what does hypothermia do to platelets and the coagulation system. I’ve sent this question to Soumaya El-Rouby at International Technidyne, Inc to see if her researchers have considered this. Geo.

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