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In Vitro Effect of Fresh Frozen Plasma on the Activated Coagulation Time in Patients Undergoing Cardiopulmonary Bypass

Received from the Departments of Anesthesiology, Internal Medicine, and the Thrombosis Research Center, Temple University Health Sciences Center, Philadelphia, Pennsylvania, Pennsylvania.

Abstract

The in vitro effect of fresh frozen plasma (FFP) on the whole blood activated coagulation time (ACT) was examined in 18 patients undergoing cardiopulmonary bypass (CPB) during coronary artery bypass graft surgery. The addition of FFP to whole blood in vitro, after systemic heparinization, significantly prolonged the ACT from 451 2 21 seconds (mean ± SE) to 572 ± 41 seconds (P > 0.05). There was no significant correlation between the plasma antithrombin 111 activity and the prolongation in ACT after systemic heparinization, with or without addition of FFP. The addition of FFP to whole blood in three of the six patients who exhibited heparin resistance (ACT <400 seconds after administration of 350 unit/kg heparin) did not prolong the ACT to >400 seconds. Theseobservations suggest that infusion of FFP will further prolong the ACT after heparin administration in most patients including some with initial heparin resistance.

Key Words: BLOOD, COAGULATION—activated coagulation time • SURGERY—cardiovascular

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Anesthesia & Analgesia® is published for the International Anesthesia Research Society® by Lippincott Williams & Wilkins with the assistance of Stanford University Libraries' HighWire Press®. Copyright 2006 by the International Anesthesia Research Society. Online ISSN: 1526-7598   Print ISSN: 0003-2999