Impact of activated clotting time on post cardiopulmonary bypass blood loss

Aim: to find the relationship of activated clotting time (act) value with clinical and laboratory profile of patient and the impact of activated clotting time (act) values on post operative blood loss. methods: this was a prospective study,performed at cardiac surgery department,king edward medical university/ mayo hospital lahore. there were 42 patients who underwent cardiopulmonary bypass (cpb) over a period of three months (01-10-2014 to 31-12-2014). to obtain desired anticoagulation for cardiopulmonary bypass,the patients were given heparin in a dose of 400 iu/kg. patients were divided into two equal groups elevated act value (> 550 seconds to 999 seconds) (n = 21) and normal act value for cpb(≤ 550 seconds) (n = 21) group. the patients were excluded from this study if they underwent off pump cabg,redo operations,had pre-existing coagulopathy,dysfunction of liver,were receiving warfarin,having a preoperative hematocrit < 25%; or were transfused with leukocyte rich blood products including fresh frozen plasma,thirty days before the surgery. hemoglobin,platelet,white blood counts,prothrombin time (inr) and partial thromboplastin time were measured by hematology laboratory according to institutional protocols. results: there was notable association in blood loss and serum act values. group one of low act value has higher blood loss as compared to other group of high act values. .group one of low act value has decreased platelet count as compared to other group of high act values having increased platelet count. other variables like,rbc's,aptt,pt,bsa,hematocrit,bypass time,cross clamp time and blood urea were not significantly influenced by act. conclusion: higher act values result in decreased postoperative blood loss and should be practiced.