Anticoagulation monitoring during cardiac surgery: a review of current and emerging techniques.


Journal Article (Review)

The literature does not consistently support the importance of anticoagulation monitoring techniques during CPB. This is best reflected by studies that have evaluated the impact of the ACT method on blood loss and transfusion outcomes. Inconsistent findings from studies that evaluated the impact of ACT monitoring may be related to either suboptimal study design (i.e., retrospective, unblinded, nonrandomized) or possibly the diagnostic inprecision of the ACT method used in these studies. There are a small number of well-controlled studies, some of which suggest that bleeding and transfusion outcomes can be improved by refining heparin monitoring techniques, either by sustaining better anticoagulation during CPB or by optimizing protamine doses (i.e., when empiric protocols result in excessive protamine doses). More well-controlled studies are needed to better define the importance of anticoagulation management during CPB.

Full Text

Duke Authors

Cited Authors

  • Despotis, GJ; Gravlee, G; Filos, K; Levy, J

Published Date

  • October 1999

Published In

Volume / Issue

  • 91 / 4

Start / End Page

  • 1122 - 1151

PubMed ID

  • 10519514

Pubmed Central ID

  • 10519514

International Standard Serial Number (ISSN)

  • 0003-3022

Digital Object Identifier (DOI)

  • 10.1097/00000542-199910000-00031


  • eng

Conference Location

  • United States