Anesthésie et recherche clinique
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Effect of Heparin Flush in Blood Drawn from Arterial Line on Activated Clotting Time and Thromboelastogram

Amit Lehavi, Vitaliy Borissovski, Avishay Zisser and Yeshayahu (Shai) Katz

The usage of low dose heparin as an additive to normal saline is a very acceptable medical practice for the maintenance of arterial line. However, heparin potentially may affect the exactness of coagulation studies carried out on blood sampled from a heparin flushed arterial line. This prospective, comparative observational study was designed to evaluate the effect of blood sampling through a heparin flushed arterial catheter on the validity of common and advanced coagulation tests including activated clotting time (ACT) and thromboelastogram (TEG). Whereas heparin flush did not affect international normalized ratio (INR) and activated partial thromboplastin time (aPTT), it significantly prolonged ACT together with the R-time and K-time components of TEG. This advocated being cautious when measuring ACT and some TEG parameters from a heparin flushed arterial line in a clinical setting.