JOURNAL HOME CME HOME THIS MONTH PAST ISSUES ETOC COLLECTIONS
AUTHORS REVIEWERS EDITORIAL BOARD FEEDBACK RSS HELP
A&A International Anesthesia Research Society
QUICK SEARCH:   [advanced]


     

Anesth Analg 1983; 62:710-719
© 1983 International Anesthesia Research Society
This Article
Right arrow Full Text (PDF)
Right arrow Alert me when this article is cited
Right arrow Alert me if a correction is posted
Services
Right arrow Email this article to a colleague
Right arrow Similar articles in this journal
Right arrow Similar articles in PubMed
Right arrow Alert me to new issues of the journal
Right arrow Download to citation manager
Citing Articles
Right arrow Citing Articles via HighWire
Right arrow Citing Articles via Google Scholar
Google Scholar
Right arrow Articles by Dauchot, P. J.
Right arrow Articles by Ankeney, J. L.
Right arrow Search for Related Content
PubMed
Right arrow PubMed Citation
Right arrow Articles by Dauchot, P. J.
Right arrow Articles by Ankeney, J. L.

Activated Coagulation and Activated Partial Thromboplastin Times in Assessment and Reversal of Heparin-Induced Anticoagulation for Cardiopulmonary Bypass

Paul J. Dauchot, MD, Ligita Berzina-Moettus, MD, Albert Rabinovitch, MD, PhD, and Jay L. Ankeney, MD

Departments of Anesthesiology, Pathology, and Surgery, Case Western Reserve University School of Medicine, and University Hospitals of Cleveland, Cleveland, Ohio.

Abstract

In 22 adult patients, activated coagulation times (ACT) were compared to activated partial thromboplastin times (aPTT) before, during, and after cardiopulmonary (CP) bypass surgery. After intravenous heparin (150 units/kg), mean ACT increased from 131 ± 14 (mean ± SD) to 362 ± 72 s (P < 0.001). With 1.5 units of heparin/ml added to the priming solution of the pump, ACT ranged from 230 to 541 s and aPTT was always 300 s or longer. Activated PTT appears to be less sensitive to changing plasma heparin levels than ACT. Heparin neutralization with a protamine/ heparin ratio of 1.0 returned ACT and aPTT to preheparin levels. No abnormal bleeding tendency was seen during the recovery period, and ACT and aPTT remained at preheparin levels. In 10 infants and children undergoing open-heart surgery, ACT was measured in response to the same heparin and protamine regimen. Baseline (113 ± 14 s) and post-heparin (297 ± 90 s) ACT were shorter in children than in adults (P < 0.01). After protamine, ACT was still longer than baseline (134 v 113 s, P < 0.05), Infants and children seem to require more heparin/kg body weight than adults to achieve comparable ACT levels.

Key Words: BLOOD: coagulation • heparin, protamine • ANESTHESIA: cardiovascular • SURGERY: cardiovascular.




This article has been cited by other articles:


Home page
 Asian Cardiovasc. Thorac. Ann.Home page
P. K. Neema, P. K. Sinha, and R. C. Rathod
Activated Clotting Time During Cardiopulmonary Bypass: Is Repetition Necessary During Open Heart Surgery?
Asian Cardiovasc Thorac Ann, March 1, 2004; 12(1): 47 - 52.
[Abstract] [Full Text] [PDF]


Lippincott, Williams & Wilkins Anesthesia & Analgesia® is published for the International Anesthesia Research Society® by Lippincott Williams & Wilkins with the assistance of Stanford University Libraries' HighWire Press®. Copyright 2006 by the International Anesthesia Research Society. Online ISSN: 1526-7598   Print ISSN: 0003-2999 HighWire Press
Copyright © 1983 by the International Anesthesia Research Society.