Monitoring of Activated Coagulation Time with Kaolin vs. Celite Activator in Cardiac Surgical Patients with Aprotinin.
- Author:
Jung Taek KIM
1
;
Kyung SUN
;
Chun Soo LEE
;
Wan Ki BAEK
;
Jeong Wook SUH
;
Hyun Tae KIM
;
Hye Sook KIM
;
Hyun Hee PARK
;
Kwang Ho KIM
Author Information
1. Department of Cardiothoracic Surgery, Inha University Hospital, Korea.
- Publication Type:Original Article
- Keywords:
Aprotinin;
Heparin;
Activated Coagulation Time
- MeSH:
Adult;
Aprotinin*;
Cardiopulmonary Bypass;
Diatomaceous Earth*;
Heparin;
Humans;
Kaolin*
- From:The Korean Journal of Thoracic and Cardiovascular Surgery
1998;31(9):873-876
- CountryRepublic of Korea
- Language:Korean
-
Abstract:
BACKGROUND: High-dose aprotinin has been reported to enhance the anticoagulant effects of heparin during cardiopulmonary bypass ; hence, som authors have advocated reducing the dose of heparin in patients treated with aprotinin. MATERIAL AND METHOD: The ACT was measured before, during and after cardiopulmonary bypass, with Hemochron 801 system using two activators of celite (C-ACT) and kaolin (K-ACT) as surface activator. From June, 1996 to February, 1997, 22 adult patients who were scheduled for elective operation were enrolled in this study. RESULT: The ACT without heparin did not differ between C-ACT and K-ACT. At 30 minutes after anticoagulation with heparin and cardiopulmonary bypass, the average C-ACT was 928+/-400 s; K-ACT was 572+/-159s (p<0.05). After administration of protamine, C-ACT was 137+/-26 s; K-ACT was 139+/-28s, which were not statistically significant. CONCLUSION: Our results showed that the significant increase in the ACT during heparin-induced anticoagulation in the presence of aprotinin was due to the use of celite as surface activator, rather than due to enhanced anticoagulation of heparin by aprotinin. We conclude that the ACT measured with kaolin provides better monitoring of cardiac surgical patients treated with high dose aprotinin than does the ACT measured with celite. The patients treated with aprotinin should receive the usual doses of heparin.
