Activated Coagulation Time Method for Control of Heparin is Reliable during Cardiopulmonary Bypass
作者:
Jerry Cohen,
期刊:
Anesthesiology
(OVID Available online 1984)
卷期:
Volume 60,
issue 2
页码: 121-124
ISSN:0003-3022
年代: 1984
出版商: OVID
关键词: Blood:;anticoagulants,;heparin;;coagulation,;protamine.;Heart:;cardiopulmonary bypass.;Surgery:;cardiac;;cardiovascular.
数据来源: OVID
摘要:
The ability of the heparin dose-activated coagulation time (ACT) response curve to predict doses of heparin during open-heart operations has been debated since its proposal. The dose-response method was examined in a statistically rigorous manner in 23 patients. The ACT response to 3 mg/kg heparin varied among patients from 308 to 520 s. Although at the start of bypass, ACTs often increased beyond the linear part of the dose-response curve (500 s), they returned to 483.7 ± 176.8 s (SD) within 1 h. After this first hour, one to four additional data points fit the initial two-point dose-response curve closely, and additional points did not significantly change dosage calculations for heparin and protamine. After a dose of protamine calculated to exactly neutralize heparin, the average ACT returned to within 7 ± 11% (SD) of control values. A two-point dose-response curve, generated for each patient before bypass begins, remains statistically valid and clinically useful throughout open-heart operations as long as the ACT is less than 500 s. The dose-response method is a simple, valid way to control coagulation during open-heart operations.
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