Abstract
The activated clotting time (ACT) is widely used for monitoring heparin anticoagulation during cardiac surgery. Celite-based ACT values are prolonged when aprotinin is administered. MDCO-2010, a novel serine protease inhibitor, is currently being evaluated as a possible alternative to aprotinin. Therefore, we evaluated the in vitro effects of this novel agent on ACT values using 3 different point-of-care instruments with kaolin or celite as an activator. The study was performed in 2 parts. In the first part, blood samples were obtained from 15 healthy volunteers. Samples were pipetted into small Eppendorf tubes and 2 concentrations of the MDCO-2010 (100 and 500 nM, final concentration) alone or with heparin (1.2 or 2.4 U/mL) were added. ACTs were measured using Helena (celite), Hemochron (kaolin), and Medtronic (kaolin) devices. In the second part of the study, blood samples were obtained intraoperatively, at 5 time points, from 15 patients undergoing cardiopulmonary bypass. MDCO-2010 at a final concentration of 100 or 500 nM was added and ACT testing was performed as before. Additional coagulation tests included prothrombin time, activated partial thromboplastin time, fibrinogen, antithrombin, prothrombin, and anti-Xa levels. ...Continue Reading
References
Dec 1, 1992·The Annals of Thoracic Surgery·D M CosgroveF D Loop
Dec 1, 1992·Anesthesiology·J S WangR B Karp
Sep 1, 1992·Circulation·S B Freedman
Jun 1, 1991·The Annals of Thoracic Surgery·M P HarderC R Wildevuur
Sep 11, 1989·The American Journal of Medicine·H R Büller, J W ten Cate
Feb 8, 1986·Lancet·J M Bland, D G Altman
Jan 1, 1981·Annals of Surgery·A T CullifordF C Spencer
Jan 1, 1995·The Journal of Thoracic and Cardiovascular Surgery·W Dietrich, M Jochum
Oct 1, 1995·Anesthesiology·W DietrichJ A Richter
Feb 1, 1993·Blood Coagulation & Fibrinolysis : an International Journal in Haemostasis and Thrombosis·H P WendelH E Hoffmeister
Aug 1, 1993·Journal of Cardiothoracic and Vascular Anesthesia·R M MoormanM E Comunale
Sep 29, 1999·Statistical Methods in Medical Research·J M Bland, D G Altman
Dec 19, 2001·Anesthesiology·M P FanashaweD L Reich
Apr 15, 2005·The Journal of Biological Chemistry·Taketoshi OgawaDavid Gailani
Sep 9, 2005·Acta Anaesthesiologica Scandinavica·A KuitunenM Salmenperä
Jul 1, 2006·Anesthesiology·Linda Shore-Lesserson, David L Reich
Jul 11, 2006·European Journal of Cardio-thoracic Surgery : Official Journal of the European Association for Cardio-thoracic Surgery·Michael T GanterChristoph K Hofer
Aug 4, 2006·Journal of Cardiothoracic and Vascular Anesthesia·Matthew P OramSusan Underwood
Aug 7, 2007·Journal of Cardiothoracic and Vascular Anesthesia·Michael T GanterChristoph K Hofer
Dec 24, 2008·Anesthesiology·Wulf DietrichAndreas van de Locht
Jan 29, 2010·The Journal of Thoracic and Cardiovascular Surgery·Gábor SzabóAndreas van de Locht
Feb 24, 2010·The Journal of Thoracic and Cardiovascular Surgery·Gábor SzabóMatthias Karck
Citations
Mar 25, 2014·Medicinal Research Reviews·Rami A Al-Horani, Umesh R Desai
Apr 12, 2014·Anesthesia and Analgesia·Lars EnglbergerThierry Carrel
Dec 5, 2017·Anesthesiology·Jerrold H LevyNigel S Key
Jun 20, 2014·Anesthesia and Analgesia·David Faraoni, Jerrold H Levy
Oct 29, 2019·Journal of Medicinal Chemistry·Torsten SteinmetzerSimon J A Wiedemeyer