COLLEGE-OF-AMERICAN-PATHOLOGISTS CONFERENCE XXXI ON LABORATORY MONITORING OF ANTICOAGULANT-THERAPY - LABORATORY MONITORING OF UNFRACTIONATED HEPARIN-THERAPY

Objective.-To review the state of the art as reflected in the medical literature and the consensus opinion of recognized experts in the fiel d regarding the laboratory monitoring of unfractionated heparin therap y. Data Sources, Extraction and Synfhesis.-The authors made an extensi ve review of the literature. The draft manuscript was circulated to ev ery participant in the consensus conference prior to the convening of the conference. Extensive discussion concerning all of the issues addr essed in the manuscript as well as the resulting recommendations occur red. This information was then used to revise the manuscript into its final form. Conclusions.-The resulting manuscript has 23 specific reco mmendations regarding preanalytic, analytic, and postanalytic phases o f monitoring and testing for complications related to unfractionated h eparin therapy. This report contains detailed discussion of these reco mmendations and includes literature citations that support them. A num ber of issues for which consensus could not be reached are also discus sed. A method is provided to assist laboratories, particularly small l aboratories, in providing clinicians with an appropriate therapeutic r ange for the activated partial thromboplastin time, the most commonly used test in monitoring heparin therapy.