ACT Values after Neutralization Lower than Pre-heparinization ACT Leads to Lower Operative Times, Bleeding, and Post-Operative Transfusions in CABG Patients: an Observational Study

Braz J Cardiovasc Surg. 2018 Nov-Dec;33(6):588-596. doi: 10.21470/1678-9741-2018-0116.

Abstract

Objective: To evaluate if lower activated coagulation time (ACT) value after neutralization than preoperative ACT value was effective in reducing bleeding, operative times, and post-operative transfusions in patients underwent coronary artery bypass grafting (CABG).

Methods: Retrospective selection of 398 patients from January 2014 to May 2017. Patients were divided into 2 groups according to final ACT after neutralization: A - final ACT lower than preoperative ACT; and B - final ACT higher than or equal to preoperative ACT. Hemostatic time, intraoperative blood loss, ACT after final neutralization, mediastinal blood loss, and transfusion requirements were observed.

Results: The hourly blood loss in the Group A was generally lower than in the Group B at first 3 hours, which has significant difference (P<0.05). However, there was no difference after 3 hours between the two groups. Operative time, intraoperative blood loss, mediastinal blood loss, transfusion requirements, and drainage in the first postoperative 12 hours in the Group A were lower than in Group B, which has significant difference (P<0.05).

Conclusion: As a result, final ACT values lower than pre-heparinization ACT values are safe and lead to lower operative times, bleeding, and post-operative transfusions.

Publication types

  • Observational Study

MeSH terms

  • Anticoagulants / therapeutic use*
  • Blood Loss, Surgical / physiopathology
  • Blood Loss, Surgical / prevention & control*
  • Coronary Artery Bypass / adverse effects*
  • Female
  • Heparin / administration & dosage*
  • Humans
  • Male
  • Middle Aged
  • Operative Time
  • Postoperative Hemorrhage / prevention & control*
  • Postoperative Period
  • Retrospective Studies
  • Whole Blood Coagulation Time

Substances

  • Anticoagulants
  • Heparin