Abstract
Activated clotting time (ACT) is an important test to measure the anticoagulation in cardiac surgeries. In this study different factors were examined which affect ACT during Coronary Artery Bypass Grafting (CABG). Blood Samples from 21 patients were taken and examined by using ACTALYKE MINI II. Once CPB initiated, the effect of hemodilution was measured on pre-CPB ACT value (P<0.05). Hemodilution occurred at the start of CPB caused a prolongation of ACT. After aorta was cross clamped, patient was cooled moderately to 32±2°C. The ACT value increased in the result (P<0.05) which proved significant. This change was due to low metabolic rate and decreased function of enzymes. Before termination patient was rewarmed to normothermia 36±1°C. This increase in temperature caused a decrease in ACT value (P<0.05). This change occurred due to an increase in metabolic rate and functioning of clotting enzymes, also there was a decrease in the blood volume due to urination. These findings can be used for better management of anticoagulation during CPB. So, ACT value has a direct relationship with hemodilution and inverse relationship with temperature.
Subject
Management of Technology and Innovation
Reference12 articles.
1. [1] Van Wyk V, Neethling W, Badenhorst P, Kotze H. r-Hirudin inhibits platelet-dependent thrombosis during cardiopulmonary bypass in baboons. Journal of Cardiovascular Surgery. 1998; 39:633.
2. [2] Bull BS, Huse WM, Brauer FS, Korpman RA. Heparin therapy during extracorporeal circulation: II. The use of a dose-response curve to individualize heparin and protamine dosage. The Journal of thoracic and cardiovascular surgery. 1975; 69:685-9.
3. [3] Kase PB, Dearing JP. Factors affecting the activated clotting time. J Extracorporeal Technol. 1985; 17:27-30.
4. [4] Shore-Lesserson L, Manspeizer HE, Bolastig M, Harrington D, Vela-Cantos F, DePerio M. Anticoagulation for cardiac surgery in patients receiving preoperative heparin: use of the high-dose thrombin time. Anesthesia & Analgesia. 2000; 90:813-8.
5. [5] Cohen EJ. Activated clotting times and cardiopulmonary bypass I: The effect of henodilution and hypothermia upon activated clotting ime. J Extra-Corporeal Technology. 1980; 12:139.