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Assays for plasma heparin are now widely utilized in the clinical laboratory and have been found to be particularly useful for monitoring heparin levels in patients receiving subcutaneous or intrapulmonary heparin and for assessing heparin reversal following cardiopulmonary bypass surgery. Three heparin assays were simultaneously used for 40 clinical samples obtained from patients receiving subcutaneous or intravenous heparin and from patients,at mid-bypass, undergoing cardiopulmonary bypass surgery. Correlation coefficients (r values) were then obtained. The heparin samples ranged from 0.04 to 5.1 units/ml. plasma heparin. The assays used were (1) chromogenic (Kabi-s2238), (2) Fluorogenic (Dade), and (3) Fibrinogen (Cutter). It was found that all assays agreed well. The r value for Cutter vs. Dade was 0.93, for Dade vs. Kabi was 0.92, and for Cutter vs. Kabi was 0.92. These studies and data would suggest that all three assays are quite acceptable for the determination of plasma heparin levels, and the relative advantages and disadvantages of each relate only to technique, time, and intrumentation requirements. Based upon these studies, ease of operation and automation, the Fluorogenic (protopath) system was chosen for monitoring heparin levels and reversal in cardiopulmonary bypass patients.

A Comparison Of Chr0M0Genic, Flu0R0Genic, And Fibrinogen Substrate Assays For The Determination Of Plasma Heparin