EFFECT OF HEPARIN-BONDED PULMONARY-ARTERY CATHETERS ON THE ACTIVATED COAGULATION TIME

Objective: This study evaluated the effect of a heparin-bonded pulmona ry artery catheter (PAC) on the activated coagulation time (ACT). Desi gn: A prospective, controlled comparison. Setting: A tertiary care uni versity hospital. Participants: Adult cardiac surgery patients. Interv entions: Celite ACTs were measured from arterial and central Venous br ood samples before and after the insertion of a heparin-bonded PAC. Th romboelastograms were also obtained from central venous blood samples before and 2 minutes after PAC insertion. Measurements and Main Result s: There was no significant difference between the sample sites before PAC insertion. After PAC insertion, the central venous ACTs were sign ificantly increased compared with the corresponding arterial measureme nts at 2, 5, 10, and 20 minutes (p < 0.005, analysis of variance [ANOV A] for repeated measures, Fisher's protected least significant differe nce [PLSD]). The 2-minute post-PAC reaction time from the central veno us blood sample was greater than 60 minutes in all cases. Conclusion: 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 minim ize the anticoagulant effects from the PAC. Copyright (C) 1998 by W.B. Saunders Company.