Activated clotting time: Difference between revisions
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The activated clotting time was introduced during the 1970s as a test to monitor the administration and subsequent reversal of unfractionated heparin (UFH) during coronary artery bypass graft surgery. Currently the test is widely used in the cardiac catheterizaiton laboratory to monitor the adequecy of UFH dosing. While practice patterns in Europe are such that a large single dose of UFH is administered for a percutaneous coronary intervention (PCI) (150 Units/per Kg), in the United States, lower doses of UFH (35 to 70U/kg depending upon the operator) are administered, and subesquent doses of UFH are titrated based upon the ACT. In the absence of a glycoprotein 2b3a inhbitor, the target ACT is usually 250 to 300 seconds. If a glycoprotein 2b3a inhibitor has been administered, the target ACT is lower, at 200 to 250 seconds. Despite the aggressive use of ACT monitoring, there is scant data to relate the value to efficacy or bleeding outcomes in the setting of PCI. | |||
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Revision as of 14:56, 15 February 2009
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Synonyms and keywords: ACT
Overview
The activated clotting time was introduced during the 1970s as a test to monitor the administration and subsequent reversal of unfractionated heparin (UFH) during coronary artery bypass graft surgery. Currently the test is widely used in the cardiac catheterizaiton laboratory to monitor the adequecy of UFH dosing. While practice patterns in Europe are such that a large single dose of UFH is administered for a percutaneous coronary intervention (PCI) (150 Units/per Kg), in the United States, lower doses of UFH (35 to 70U/kg depending upon the operator) are administered, and subesquent doses of UFH are titrated based upon the ACT. In the absence of a glycoprotein 2b3a inhbitor, the target ACT is usually 250 to 300 seconds. If a glycoprotein 2b3a inhibitor has been administered, the target ACT is lower, at 200 to 250 seconds. Despite the aggressive use of ACT monitoring, there is scant data to relate the value to efficacy or bleeding outcomes in the setting of PCI.