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The Journal of Thoracic and Cardiovascular Surgery, Vol 79, 97-102, Copyright © 1980 by The American Association for Thoracic Surgery and The Western Thoracic Surgical Association
BF Akl, GM Vargas, J Neal, J Robillard and P Kelly
The clinical experience with the activated clotting time (ACT) for the
control of heparin and protamine therapy during cardiopulmonary bypass in
70 patients (50 adults and 20 children) is reviewed. After a standard dose
of 2 mg/kg of body weight of heparin, the patient's ACT ranged from 210 to
more than 600 seconds. The heparin dose required to accomplish an ACT of
500 seconds ranged from 1.3 to 4.7 mg/kg for adults and from 2 to 4.5 mg/kg
for children. At the termination of bypass, the assessment of the patient's
heparin level with the ACT allowed a more accurate reversal with protamine
and markedly reduced the protamine requirements. Although the postoperative
drainage was not significantly decreased, the total amount of blood
transfusion and fresh-frozen plasma and platelet requirements were reduced
by 30%, 20%, and 20% respectively. The simple, easy-to-use protocol is
presented in detail.
ARTICLES
Clinical experience with the activated clotting time for the control of heparin and protamine therapy during cardiopulmonary bypass
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