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CARDIOVASCULAR ANESTHESIA

The Effect of Epsilon-Aminocaproic Acid on HemoSTATUS® and Kaolin-Activated Clotting Time Measurements

Rao Saleem, MD^*, Matthew Bigham, MD^*, Edward Spitznagel, PhD, and George J. Despotis, MD^*,

Departments of *Anesthesiology and Immunology and Pathology, Division of Biostatistics, Washington University School of Medicine, St. Louis, Missouri

Address correspondence and reprint requests to George Despotis, MD, Department of Anesthesiology, Box 8054, Washington University School of Medicine, 660 South Euclid Ave., St. Louis, MO 63110.

New point-of-care assays have been used to identify patients with heparin resistance (i.e. heparin dose response test; Medtronic Blood Management, Parker, CO) and who have platelet dysfunction (i.e. HemoSTATUS®; Medtronic Blood Management). We examined the effect of epsilon-aminocaproic acid on results from these two point-of-care tests in patients undergoing cardiac surgery. Twenty patients scheduled for elective cardiac surgical procedures were enrolled in this prospective study. HemoSTATUS® clot ratio (% maximal) values in Channels (Ch) 3–6 (Ch 3: 26 ± 25, Ch 4: 66 ± 23, Ch 5: 84 ± 20, Ch 6: 106 ± 18) obtained after the IV administration of epsilon-aminocaproic acid were similar to values obtained before the administration of this agent (Ch 3: 26 ± 20, Ch 4: 69 ± 23, Ch 5: 86 ± 19, Ch 6: 109 ± 14). Slope values (86 ± 23 s · U^-1 · mL^-1) and projected heparin concentrations (4 ± 1 U/mL) obtained before the administration of epsilon-aminocaproic acid were similar to slope values (88 ± 21 s · U^-1 · mL^-1) and projected heparin concentrations (4 ± 1 U/mL) values obtained after administration of this agent. Our data indicate that HemoSTATUS® clot ratio values and heparin dose response values are not significantly affected after IV dosing of epsilon-aminocaproic acid.

Implications: Values from two activated coagulation time-based test systems used to identify significant heparin resistance or platelet dysfunction after cardiopulmonary bypass were not significantly affected by epsilon-aminocaproic acid administered IV.

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