Abstract
Monitoring of the adequacy of anticoagulation is essential to the safe conduct of cardiopulmonary bypass (CPB). While there is no universally accepted heparin level or test of adequate anticoagulation during cardio-pulmonary bypass, the automated activated clotting time (Hemochron ACT) became the routine method of monitoring heparinization in most cardiac centers, because of its simplicity, rapidity, and an observed linear relationship to the heparin dose [2, 3, 10]. However, hemodilution, coagulation-factor depletion, and hypothermia have all been shown to influence ACT and, thus, may lead to a non-heparin-induced prolongation of ACT. Furthermore, there is also no universally accepted safe minimum ACT for CPB [6, 12].
This is a preview of subscription content, log in via an institution.
Buying options
Tax calculation will be finalised at checkout
Purchases are for personal use only
Learn about institutional subscriptionsPreview
Unable to display preview. Download preview PDF.
References
Bidstrup BP, Royston D, Sapsford RN, Taylor KM (1989) Reduction in blood loss and blood use after cardiopulmonary bypass with high dose aprotinin (Trasylol). J Thorac Cardiovasc Surg 97: 364–372
Blohn von G, Hellstern P, Köhler M, Scheffler P, Wenzel E (1986) Klinische Gesichtspunke des erworbenen Antithrombin III-Mangels. Behring Inst Mitt 79: 200–215
Bull BS, Korpman RA, Huse WM, Briggs BD (1975) Heparin therapy during extracorporeal circulation. I. Problems inherent in existing heparin protocols. J Thorac Cardiovasc Surg 69: 674–684
Cohen EJ, Camerlengo LJ, Dearing JP (1980) Activated clotting times and cardiopulmonary bypass I: The effect of hemodilution and hypothermia upon activated clotting time. J Extra-Corp Tech 12: 139–141
Culliford AT, Gitel SN, Starr N, Thomas ST, Baumann FG, Wessler S, Spencer FC (1981) Lack of correlation between activated clotting time and plasma heparin during cardiopulmonary bypass. Ann Surg 193: 105–111
Esposito RA, Culliford AT, Colvin SB, Thomas SJ, Lackner H, Spencer FC (1983) The role of the activated clotting time in heparin administration and neutralization for cardiopulmonary bypass. J Thorac Cardiovasc Surg 85: 174–185
Hughes DR, Faust RJ, Didisheim P, Tinker JH (1982) Heparin monitoring during cardiopulmonary bypass in man: Use of fluorogenic heparin assay to validate activated clotting time. Anesthesia and Analgesia 61: 189–190
Preiss DU, Schmidt-Bleibtreu H, Berguson P, Metz G (1985) Blood transfusion requirements in coronary artery surgery with and without the activated clotting time (ACT) technique. Klin Wochenschr 63: 252–256
Preiss DU, Zobeley R (1983) Individuelle Heparin- und Protamindosierung in der Herzchirurgie. Klin Wochenschr 61: 1141–1146
Schriever HG, Epstein SE, Mintz MD (1973) Statistical correlation and heparin sensitivity of activated partial thromboplastin time, whole blood coagulation time and an automated coagulation time. Am J of Clin Path 60: 323–329
Witt I, Herz R, Lill H (1984) Heparin. In: Methods of enzymatic analysis. HU Bergmeyer (Ed) Verlag Chemie, Weinheim, Bergstr. p 477–486
Young JA, Kisker CT, Doty DB (1978) Adequate anticoagulation during cardiopulmonary bypass determined by activated clotting time and the apparance of fibrin monomer. Ann Thorac Surg 26: 231–240
Author information
Authors and Affiliations
Editor information
Editors and Affiliations
Rights and permissions
Copyright information
© 1991 Springer-Verlag Berlin Heidelberg
About this paper
Cite this paper
Preiss, D.U., Witt, I., Kiefer, H., Betz, P. (1991). ACT and Aprotinin. In: Friedel, N., Hetzer, R., Royston, D. (eds) Blood Use in Cardiac Surgery. Steinkopff, Heidelberg. https://doi.org/10.1007/978-3-662-06119-0_40
Download citation
DOI: https://doi.org/10.1007/978-3-662-06119-0_40
Publisher Name: Steinkopff, Heidelberg
Print ISBN: 978-3-662-06121-3
Online ISBN: 978-3-662-06119-0
eBook Packages: Springer Book Archive