Why the study?
How do the activated coagulation time test (ACT) and quantitative protamine titration test (QPT) compare in variability and susceptibility to population variables for monitoring heparin therapy during cardiopulmonary bypass?
How do the activated coagulation time test (ACT) and quantitative protamine titration test (QPT) compare in variability and susceptibility to population variables for monitoring heparin therapy during cardiopulmonary bypass?
The activated coagulation time (ACT) test is a reliable method for monitoring heparin during cardiopulmonary bypass, as it is unaffected by population variables like plasma volume when used with a dose-response curve.
ACT with dose-response curves may reliably monitor heparin in CPB; leaves open superiority over QPT pending higher-level evidence.
Two tests, the activated coagulation time test (ACT), and the quantitative protamine titration test (QPT), were examined in detail as representative of a large number of tests potentially useful in determining dose of heparin needed during cardiopulmonary bypass and the dose of protamine needed for reversal of heparin. The variability introduced by the test methods (ACT 6 percent, QPT 8 per cent) was insignificant comparen (greater than 25 per cent) and the variation in plasma volume (14 per cent). Both of these variables affected not only QPT but also any modification of it that measures the level of heparin by titration with protamine solutions. Tests that measure the effect of heparin on the clotting time, of which the ACT is an example, were unaffected by either population variable when used in conjunction with a simply constructed dose-response curve.
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Huse et al. (1975) studied this question.
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