University of Oulu

Erkinaro, T., Moilanen, J., Lahtinen, J., Mosorin, M., & Savolainen, E.-R. (2022). The standard point-of-care hemochron jr. Act+ test in monitoring heparin administration for cardiopulmonary bypass in severe factor xii deficiency. Journal of Cardiothoracic and Vascular Anesthesia, 36(7), 2031–2034. https://doi.org/10.1053/j.jvca.2021.05.021

The standard point-of-care Hemochron Jr. ACT+ test in monitoring heparin administration for cardiopulmonary bypass in severe factor XII deficiency

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Author: Erkinaro, Tiina1; Moilanen, Janne1; Lahtinen, Jarmo1;
Organizations: 1Research Group of Surgery, Anesthesiology and Intensive Care Medicine, Medical Research Center Oulu, Oulu University Hospital, University of Oulu, Finland
2Nordlab Oulu Hematology Laboratory, Medical Research Center Oulu, Oulu University Hospital, University of Oulu, Finland
Format: article
Version: published version
Access: open
Online Access: PDF Full Text (PDF, 0.4 MB)
Persistent link: http://urn.fi/urn:nbn:fi-fe2022102763551
Language: English
Published: Elsevier, 2022
Publish Date: 2022-10-27
Description:

Abstract

Coagulation factor XII (FXII) is a plasma serine protease that belongs to the contact activation complex responsible for initiating the intrinsic coagulation pathway. FXII deficiency is a rare congenital disorder that is not associated with an increased tendency for bleeding. However, as contact activation is impaired in FXII deficiency, both the celite- and kaolin-initiated activated clotting time (ACT) measurements are prolonged markedly, which poses a challenge for anticoagulation monitoring in patients undergoing cardiac surgery. The authors successfully have used the standard Hemochron Jr. ACT+ test, which is activated by silica and phospholipid in addition to kaolin, to monitor anticoagulation for cardiopulmonary bypass in two patients with severe FXII deficiency. The ACT+ test showed low baseline values, increased adequately in response to heparin, and decreased to baseline after protamine. Importantly, there was no abnormal intra- or postoperative bleeding nor any thrombotic complications. Furthermore, in vitro dose-response ACT+ testing of FXII-deficient blood with increasing heparin concentrations supports the use of ACT+ in FXII deficiency.

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Series: Journal of cardiothoracic and vascular anesthesia
ISSN: 1053-0770
ISSN-E: 1532-8422
ISSN-L: 1053-0770
Volume: 36
Issue: 7
Pages: 2031 - 2034
DOI: 10.1053/j.jvca.2021.05.021
OADOI: https://oadoi.org/10.1053/j.jvca.2021.05.021
Type of Publication: A1 Journal article – refereed
Field of Science: 3126 Surgery, anesthesiology, intensive care, radiology
Subjects:
Copyright information: © 2021 The Author(s). This is an open access article under the CC BY-NC-ND license (http://creativecommons.org/licenses/by-nc-nd/4.0/)
  https://creativecommons.org/licenses/by-nc-nd/4.0/