[Control of temporary anticoagulation in extracorporeal circulation using activated coagulation time].
The customary use of standardized regimens for heparin anticoagulation and its neutralization by protamine in cardiopulmonary bypass may result in gross over- or underdosage of either substance with resulting clinical problems. Heparin and protamine doses, postoperative blood loss during the first 20 h and the need for bank blood in a group of 100 patients following a fixed heparin-protamine protocol were compared with another group of 106 cases with ACT-guided heparin and protamine dosage. In the ACT-group the mean heparin dose was 22.5% less (3.57 mg/kg and 4.60 mg/kg respectively) than in the standard group. Protamine doses fell by 58.5% from 5.11 mg/kg to 2.12 mg/kg in the ACT-group. The mean postoperative blood loss in the ACT-cases was 4.54 ml/kg/20h, 2.29 ml respectively 33.5% less than that of control group. The demand for bank blood in the ACT-group was 1.97 units opposed to 5.12 units in the standardized regimen group.
D000328:Adult; D001777:Blood Coagulation / Q000187:drug effects*; D001780:Blood Coagulation Tests; D001803:Blood Transfusion; D005112:Extracorporeal Circulation; D006331:Heart Diseases / Q000601:surgery*; D006493:Heparin / Q000627:therapeutic use*; D006801:Humans; D011479:Protamines / Q000627:therapeutic use; D014914:Whole Blood Coagulation Time
D011479:Protamines; D006493:Heparin
Zur Steuerung der temporären Antikoagulation während des extrakorporalen Kreislaufs mit Hilfe der aktivierten Gerinnungszeit.