Pro: Activated Clotting Time Should Be Monitored During Heparinization For Vascular Surgery

Abstract

HEPARIN FREQUENTLY IS ADMINISTERED to provide anticoagulation for prevention of thrombosis and ischemia during vascular surgery. Heparinization during major vascular procedures in which an arterial clamp is applied is universal; however, monitoring the anticoagulant effect of heparin is not routine at all medical centers. Heparin effect may be monitored in a number of ways. Initial clotting time measurements are accomplished by placing whole blood in a glass tube and tilting the tube until blood fluidity is lost. The Lee-White whole blood clotting time relies upon the glass tube to “activate” the clotting cascade and catalyze clot formation. 1 Kaplan J.A. Reich D. Savino J. Cardiac Anesthesia.6th ed. Elsevier, St. Louis, MO2011: 496-516 Google Scholar With increasing amounts of heparin, however, this test is time consuming and labor intensive.