Whole blood activated clotting time in infants during extracorporeal membrane oxygenation.

摘要: Bleeding complications are the principal cause of morbidity and mortality in infants treated with extracorporeal membrane oxygenation (ECMO). The whole blood activated clotting time (ACT) test is used universally to monitor heparin therapy during this procedure. To enhance our understanding improve management anticoagulation, we studied relationship between ACT concentration nine ECMO. correlated simultaneously determined (r = .55, p less than .001 for all patients samples; r .92, mean values). Within range values found patients, platelet count, fibrinogen, fibrin degradation products did not affect ACT-heparin relationship. However, interpretation an individual result was limited by its low precision: difference duplicate determinations 9.2%, estimation a single had coefficient variation 32%. Two commercially available techniques using different activators gave results that differed numerically but well each other. Both provided similar precision concentration. cost, bedside whose accuracy allow achievement target concentrations required Multiple determinations, either or serially, needed achieve satisfactory precision. These data will be useful designing future studies determine optimal serum provide adequate avoid bleeding complications.