Effect of heparin-bonded pulmonary artery catheters on the activated coagulation time. 1998

S E McNulty, and D P Maguire, and R E Thomas
Department of Anesthesiology, Jefferson Medical College, Thomas Jefferson University, Philadelphia, PA 19107-5092, USA.

OBJECTIVE This study evaluated the effect of a heparin-bonded pulmonary artery catheter (PAC) on the activated coagulation time (ACT). METHODS A prospective, controlled comparison. METHODS A tertiary care university hospital. METHODS Adult cardiac surgery patients. METHODS Celite ACTs were measured from arterial and central venous blood samples before and after the insertion of a heparin-bonded PAC. Thromboelastograms were also obtained from central venous blood samples before and 2 minutes after PAC insertion. RESULTS There was no significant difference between the sample sites before PAC insertion. After PAC insertion, the central venous ACTs were significantly increased compared with the corresponding arterial measurements at 2, 5, 10, and 20 minutes (p < 0.005, analysis of variance [ANOVA] for repeated measures, Fisher's protected least significant difference [PLSD]). The 2-minute post-PAC reaction time from the central venous blood sample was greater than 60 minutes in all cases. CONCLUSIONS The heparin-bonded PAC was associated with a localized, time-dependent alteration in the ACT. Whenever possible, blood samples for baseline ACT measurements should be obtained from an arterial catheter to minimize the anticoagulant effects from the PAC.

UI MeSH Term Description Entries
D011446 Prospective Studies Observation of a population for a sufficient number of persons over a sufficient number of years to generate incidence or mortality rates subsequent to the selection of the study group. Prospective Study,Studies, Prospective,Study, Prospective
D002407 Catheterization, Swan-Ganz Placement of a balloon-tipped catheter into the pulmonary artery through the antecubital, subclavian, and sometimes the femoral vein. It is used to measure pulmonary artery pressure and pulmonary artery wedge pressure which reflects left atrial pressure and left ventricular end-diastolic pressure. The catheter is threaded into the right atrium, the balloon is inflated and the catheter follows the blood flow through the tricuspid valve into the right ventricle and out into the pulmonary artery. Catheterization, Pulmonary Artery,Swan-Ganz Catheterization,Pulmonary Artery Catheterization,Artery Catheterization, Pulmonary,Artery Catheterizations, Pulmonary,Catheterization, Swan Ganz,Catheterizations, Pulmonary Artery,Pulmonary Artery Catheterizations,Swan Ganz Catheterization
D006493 Heparin A highly acidic mucopolysaccharide formed of equal parts of sulfated D-glucosamine and D-glucuronic acid with sulfaminic bridges. The molecular weight ranges from six to twenty thousand. Heparin occurs in and is obtained from liver, lung, mast cells, etc., of vertebrates. Its function is unknown, but it is used to prevent blood clotting in vivo and vitro, in the form of many different salts. Heparinic Acid,alpha-Heparin,Heparin Sodium,Liquaemin,Sodium Heparin,Unfractionated Heparin,Heparin, Sodium,Heparin, Unfractionated,alpha Heparin
D006801 Humans Members of the species Homo sapiens. Homo sapiens,Man (Taxonomy),Human,Man, Modern,Modern Man
D000328 Adult A person having attained full growth or maturity. Adults are of 19 through 44 years of age. For a person between 19 and 24 years of age, YOUNG ADULT is available. Adults
D000925 Anticoagulants Agents that prevent BLOOD CLOTTING. Anticoagulant Agent,Anticoagulant Drug,Anticoagulant,Anticoagulant Agents,Anticoagulant Drugs,Anticoagulation Agents,Indirect Thrombin Inhibitors,Agent, Anticoagulant,Agents, Anticoagulant,Agents, Anticoagulation,Drug, Anticoagulant,Drugs, Anticoagulant,Inhibitors, Indirect Thrombin,Thrombin Inhibitors, Indirect
D014914 Whole Blood Coagulation Time The time required by whole blood to produce a visible clot. Activated Coagulation Time, Whole Blood,Blood Coagulation Time, Whole,Coagulation Time, Whole Blood

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