Use of Activated Coagulation Time to Monitor Heparin during Cardiac Surgery

Roth, Jack A.; Cukingnan, Ramon A.; Scott, Calvin R.

doi:10.1016/s0003-4975(10)63396-6

Cited by 25 publications

(8 citation statements)

References 11 publications

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“…358,359 Studies in adults using ACT alone or combined with heparin concentration assays compared with empirical dosing demonstrate that these tests generally either result in a decrease in postoperative bleeding or transfusion requirements or at worst have neutral results, suggesting that the use of these tests to guide heparin therapy is probably beneficial. [360][361][362][363][364][365][366][367][368][369][370][371][372][373][374][375][376][377] The anticoagulation strategies for children are borrowed from the adult experience, and few studies address the pediatric age range specifically, despite the fact that factors known to prolong ACT, such as hypothermia, hemodilution, and decreased platelet function, are prevalent in pediatric cardiac operations. The optimal target ACT that will prevent clot formation within the CPB circuit is not precisely known, but clot formation is unlikely with an ACT >300 seconds.…”

Section: General Comments On Anticoagulation For Cpb In Children Withmentioning

confidence: 99%

Prevention and Treatment of Thrombosis in Pediatric and Congenital Heart Disease

Giglia¹,

Massicotte²,

Tweddell³

et al. 2013

Circulation

285

245

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Section: General Comments On Anticoagulation For Cpb In Children Withmentioning

confidence: 99%

Prevention and Treatment of Thrombosis in Pediatric and Congenital Heart Disease

Giglia¹,

Massicotte²,

Tweddell³

et al. 2013

Circulation

285

245

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“…It is known that heparin can, by itself, unchain a consumption coagulopathy [19,25] acting as a hapten for an antiplatelet antibody, causing thrombopenia and lower ing factor VII and FBG concentrations. In our experiments this phenomenon does not seem to have occurred: the consumption of factors is more evident in the absence of hep arin and there is no difference between using 1 and 3 mg of heparin/kg body weight with respect to the coagulation tests, as is the case with the PLAT, the decrease of which was significatively more marked in the nonheparinized group.…”

Section: Discussionmentioning

confidence: 99%

Coagulation Defects during Extracorporeal Circulation in the Dog

Álvarez¹,

Escudero²,

Rodríguez³

et al. 1987

Eur Surg Res

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This study was undertaken in an attempt to diminish the frequency and severity of postextracorporeal circulation hemorrhage in dogs. Its purpose is to ascertain the amount of ^99mTc-labeled autologous fibrinogen deposited in the oxygenator, as well as the coagulation defect originated during the surgical procedure when heparin is not administered (group I) and when it is at doses of 1 mg/kg body weight (group II) and 3 mg/kg body weight (group III). The result demonstrate that the fibrinogen deposition in the oxygenator decreased as the dose of heparin administered was augmented. The coagulation disorders were produced by factor consumption, affecting all dogs in group I. The same type of alteration was produced with the use of heparin, but in some the platelet count, fibrinogen and fibrinogen degradation products and the prothrombin and thrombin times were maintained within normality or were only slightly altered. Significant differences were not detected between groups II and III. For this reason, we recommend the utilization of heparin in experimental extracorporeal circulation in a single dose of 1 mg/kg body weight, administered at the initiation of bypass, which provides a sufficient level of anticoagulation for at least 60 min and makes its neutralization with protamine unnecessary, the effects of which are especially adverse in the dog.

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“…The activated whole blood clotting time (ACT) was used to monitor heparin therapy [6][7][8]. The dose of heparin and protamine was calculated from the dose-response curve according to the method of Bull etal.…”

Section: Methodsmentioning

confidence: 99%

Monitoring of Anticoagulant Therapy during Open-Heart Surgery in Children with Congenital Heart Disease

Jumean

Sudah²

1983

Acta Haematol

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A significant reduction (30%) in the amount of postoperative blood loss from 1.12 to 0.70 ml/kg/h was noted in pediatric patients subjected to cardiopulmonary bypass for congenital heart disease surgery when the activated whole blood clotting time was utilized to monitor anticoagulant therapy. However, no difference in the incidence (11 %) of postoperative hemorrhage was noted. Extensive preoperative laboratory hemo-stasis testing and routine immediate postoperative use of platelet transfusion and fresh frozen plasma (in cyanotic heart defects) failed to predict or correct those patients with significant postoperative hemorrhage.

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Use of Activated Coagulation Time to Monitor Heparin during Cardiac Surgery

Cited by 25 publications

References 11 publications

Prevention and Treatment of Thrombosis in Pediatric and Congenital Heart Disease

Prevention and Treatment of Thrombosis in Pediatric and Congenital Heart Disease

Coagulation Defects during Extracorporeal Circulation in the Dog

Monitoring of Anticoagulant Therapy during Open-Heart Surgery in Children with Congenital Heart Disease

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