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- W2465882610 abstract "CARDIAC SURGERY presents unique challenges in the management of coagulation because of the requirement for both a fully anticoagulated state for cardiopulmonary bypass (CPB) and a return-to-normal hemostasis at its conclusion. The activated clotting time (ACT) is employed most commonly to assess anticoagulation and ensure adequate heparin and protamine dosing. Despite the routine use of ACT, many studies have demonstrated a lack of correlation between plasma heparin levels and ACT during CPB. 1 Despotis G.J. Summerfield A.L. Joist J.H. et al. Comparison of activated coagulation time and whole blood heparin measurements with laboratory plasma anti-Xa heparin concentration in patients having cardiac operations. J Thorac Cardiovasc Surg. 1994; 108: 1076-1082 Abstract Full Text PDF PubMed Scopus (184) Google Scholar , 2 Raymond P.D. Ray M.J. Callen S.N. et al. Heparin monitoring during cardiac surgery. Part 1: Validation of whole-blood heparin concentration and activated clotting time. Perfusion. 2003; 18: 269-276 Crossref PubMed Scopus (74) Google Scholar , 3 Hashimoto K. Sasaki T. Hachiya T. et al. Real time measurement of heparin concentration during cardiopulmonary bypass. J Cardiovasc Surg (Torino). 1999; 40: 645-651 Google Scholar Conditions during CPB, such as hemodilution, hypothermia, platelet activation, and coagulopathy also are known to cause falsely elevated ACT readings. 4 Martindale S.J. Shayevitz J.R. D’Errico C. The activated coagulation time: Suitability for monitoring heparin effect and neutralization during pediatric cardiac surgery. J Cardiothorac Vasc Anesth. 1996; 10: 458-463 Abstract Full Text PDF PubMed Scopus (51) Google Scholar , 5 Despotis G.J. Gravlee G. Filos K. et al. Anticoagulation monitoring during cardiac surgery: A review of current and emerging techniques. Anesthesiology. 1999; 91: 1122-1151 Crossref PubMed Scopus (243) Google Scholar For these reasons, relying on the ACT alone may lead to inadequate anticoagulation." @default.
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- W2465882610 date "2016-12-01" @default.
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- W2465882610 title "Pro: The Hepcon HMS Should Be Used Instead of Traditional Activated Clotting Time (ACT) to Dose Heparin and Protamine for Cardiac Surgery Requiring Cardiopulmonary Bypass" @default.
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- W2465882610 doi "https://doi.org/10.1053/j.jvca.2016.07.001" @default.
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