Document Detail

A novel thrombelastograph tissue factor/kaolin assay of activated clotting times for monitoring heparin anticoagulation during cardiopulmonary bypass.
MedLine Citation:
PMID:  15502019     Owner:  NLM     Status:  MEDLINE    
We used a thrombelastograph (TEG) assay with tissue factor and kaolin (TEG TF/K) to measure activated clotting time (ACT) in 31 patients during cardiopulmonary bypass. For comparison, ACTs were also determined by a Hemochron Jr. Signature and a Hepcon HMS. The TEG TF/K correlated with both the Hepcon (r(2) = 0.789) and Hemochron (r(2) = 0.743) ACTs. The average ACT after heparin was 319 +/- 119 s (mean +/- sd) for the TEG TF/K compared with 624 +/- 118 s for the Hepcon instrument. To evaluate the effects of hemodilution on TEG TF/K and Hemochron assays, ACT assays were performed on blood diluted to 50% and titrated with heparin from 0 to 6 U/mL. Both instruments showed significant (P < 0.01) changes in the ACT-versus-heparin slope, but the 0 heparin intercept for the TEG TF/K ACTs was not significantly changed (P = 0.292), in contrast to that for the Hemochron device (P = 0.041). Both instruments also indicated the same 1.3:1 ratio of protamine to heparin for optimum heparin neutralization, with increasing ACTs at ratios >2.6:1. The TEG TF/K ACT assay rapidly monitors heparin anticoagulation, in addition to the capabilities of this instrument to monitor platelet function, clotting factors, and fibrinolysis.
Jack J Chavez; Donald E Foley; Carolyn C Snider; James C Howell; Eli Cohen; Robert A Muenchen; Roger C Carroll
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Publication Detail:
Type:  Clinical Trial; In Vitro; Journal Article; Research Support, Non-U.S. Gov't    
Journal Detail:
Title:  Anesthesia and analgesia     Volume:  99     ISSN:  0003-2999     ISO Abbreviation:  Anesth. Analg.     Publication Date:  2004 Nov 
Date Detail:
Created Date:  2004-10-25     Completed Date:  2004-11-26     Revised Date:  2006-11-15    
Medline Journal Info:
Nlm Unique ID:  1310650     Medline TA:  Anesth Analg     Country:  United States    
Other Details:
Languages:  eng     Pagination:  1290-4; table of contents     Citation Subset:  AIM; IM    
Department of Anesthesiology, University of Tennessee Medical Center, 1924 Alcoa Highway, Knoxville, TN 37920, USA.
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MeSH Terms
Aged, 80 and over
Anticoagulants / pharmacology*
Blood Coagulation / drug effects
Cardiopulmonary Bypass*
Hemostatics / diagnostic use*
Heparin / pharmacology*
Kaolin / diagnostic use*
Middle Aged
Protamines / pharmacology
Thromboplastin / diagnostic use*
Whole Blood Coagulation Time*
Reg. No./Substance:
0/Anticoagulants; 0/Hemostatics; 0/Protamines; 0/protamine zinc; 1332-58-7/Kaolin; 9005-49-6/Heparin; 9035-58-9/Thromboplastin

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