TITLE

Measurement of the activated clotting time during cardiopulmonary bypass: differences between Hemotec® ACT and Hemochron® Jr apparatus

AUTHOR(S)
Svenmarker, S.; Appelblad, M.; Jansson, E.; Häggmark, S.
PUB. DATE
September 2004
SOURCE
Perfusion;Sep2004, Vol. 19 Issue 5, p289
SOURCE TYPE
Academic Journal
DOC. TYPE
Article
ABSTRACT
Background: Measurement of the activated clotting time (ACT) represents a standard method for coagulatory assessments. The test employs specific agents to trigger the coagulation process. The present study aimed to compare kaolin (Hemotec®) versus a combination of silica, kaolin and phospholipid (Hemochron® Jr) ACTs. Methods: Hemotec® and Hemochron® Jr ACT monitors were compared by simultaneous measurement of paired arterial blood samples (n = 114) with respect to precision and bias during clinical conditions of cardiopulmonary bypass (CPB). The influence of haemodilution on the ACT was tested in an ex-vivo model. Results: The precision of Hemotec® and Hemochron® Jr ACT measurements attained 21 ± 2.6 s versus 27.0 ± 2.6 s (p = 0.126) during CPB and 2.5 ± 2.2 s versus 9.4 ± 6.9 s (p = 0.000) after protamine administration, respectively. The Hemochron® Jr monitor was associated with a bias of −102 ± 13.7 s compared to the Hemotec® ACT monitor (p = 0.000) during CPB and −6.9 ± 2.9 s after protamine (p = 0.025). Linear regression analysis of ACT readings between monitors reached r = 0.526 (p = 0.000). Hemochron® Jr ACT values correlated with the erythrocyte volume fraction r = 0.379 (p = 0.000). Ex-vivo data indicated that the Hemotec® ACT monitor was associated with relatively higher ACT readings after haemodilution. Conclusion: The ACT is not a standardized measure. Test results are strongly associated with the specific compounds used to initiate the coagulation process.
ACCESSION #
14509732

 

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