Monitoring Heparin Prophylaxis

  • J. G. Sharnoff


The monitoring of heparin prophylaxis has long been a problem. As a result, many tests have been devised but have proved unsatisfactory for one reason or another. It was shortly before the discovery of heparin by McLean in 1916 that the Lee-White coagulation time test (1913) for blood was introduced and later used to determine the effect of heparin on coagulation. In general blood coagulation time has for many years been relied upon as the best method available. The test is performed by drawing 3 ml of venous blood in a dry glass syringe. With the needle removed, 1 ml of blood is delivered into three test tubes of standard size, 13 × 100 mm. A stopwatch is started when the blood is drawn into the syringe. The tubes are placed in a water bath at 37°C and after 2 minutes tilted every 30 seconds. When clotting is noted in each tube the times are recorded and their average is reported as the coagulation time; the normal range is 5–10 minutes. The test is not precise chiefly because of the difficulty in determining the end-point and is therefore less than satisfactory. An equally unsatisfactory and little used test is the capillary tube test where fingertip blood is allowed to fill capillary glass tubes of 1 mm diameter and 5 cm length; a stopwatch is started and the tubes are broken every 30 seconds until a fibrin thread is seen between the broken ends. The normal range is 3–5 minutes.


Partial Thromboplastin Time Activate Partial Thromboplastin Time Heparin Therapy Wound Haematoma Heparin Prophylaxis 
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Copyright information

© J. G. Sharnoff 1980

Authors and Affiliations

  • J. G. Sharnoff
    • 1
  1. 1.The Mount Vernon HospitalMount VernonUSA

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