Issue |
J Extra Corpor Technol
Volume 28, Number 1, March 1996
|
|
---|---|---|
Page(s) | 16 - 20 | |
DOI | https://doi.org/10.1051/ject/199628116 | |
Published online | 18 August 2023 |
Original Article
Modified Microsample ACT Test for Heparin Monitoring
1
Hospital of University of Pennsylvania, Philadelphia, PA
2
Hospital of University of Pennsylvania, Philadelphia, PA
3
Philadelphia Heart Institute, Philadelphia, PA
4
The University of Chicago, Chicago, IL
5
The Johns Hopkins Hospital, Baltimore, MD, and International Technidyne Corp., Edison, NJ
* Address correspondence to: Chi-Miau Pan. PhD, Research Division, International Technidyne Corp., 8 Olsen Avenue, Edison, NJ 08820
The activated clotting time (ACT) is a standard method of heparin monitoring during cardiac angioplasty and cardiac surgery. A modified ACT (ACT+) which employs a microsample blood volume (0.05 ml) and yields faster clotting time results than a conventional Hemochron ACT was evaluated and compared to the standard ACT.
The ACT+, determined using a single channel general purpose analyzer (Hemochron Jr.), employs a plastic cuvette containing dried ACT reagents (kaolin-silica-phospholipid). In vitro evaluation of heparinized normal donor blood demonstrated the test insensitivity to aprotinin. Using split blood specimens, duplicate ACT and ACT+ were performed (n=92) and a correlation between the two was established.
In evaluation of 79 cardiac surgery and 53 angioplasty patients, good correlation was observed between ACT+ and Hemochron ACT (r=0.93, n=574). Mean versus difference plots demonstrated an improved reproducibility of the ACT+ (Mean SD=35 seconds) compared to the ACT (Mean SD=53 seconds), presumably due to automation of the blood sample sizing and blood/reagent mixing. These studies indicate that the microsample ACT+ is an alternative to the conventional ACT with an advantage of small sample requirement and rapid reproducible results.
Key words: activated clotting time / heparin / anticoagulation / dose-response / aprotinin
© 1996 AMSECT
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