In vitro effect of fresh frozen plasma on the activated coagulation time in patients undergoing cardiopulmonary bypass

• Published in: Anesthesia and analgesia Vol. 67; no. 1; pp. 57 - 60
• Main Authors: BARNETTE, R. E, SHUPAK, R. C, PONTIUS, J, KONETI RAO, A
• Format: Journal Article
• Language: English
• Published: Hagerstown, MD Lippincott 1988
• Subjects: Adult; Aged; Anesthesia; Anesthesia depending on type of surgery; Anesthesia. Intensive care medicine. Transfusions. Cell therapy and gene therapy; Antithrombin III - analysis; Biological and medical sciences; Blood Coagulation; Blood Transfusion; Cardiopulmonary Bypass; Coronary Artery Bypass; Drug Resistance; Female; Heparin - administration & dosage; Humans; In Vitro Techniques; Male; Medical sciences; Middle Aged; Plasma; Thoracic and cardiovascular surgery. Cardiopulmonary bypass; Time Factors; Whole Blood Coagulation Time; Cardiopulmonary bypass; Human; Blood coagulation; Fresh blood; General anesthesia; Frozen product; Activated clotting time; Blood plasma
• ISSN: 0003-2999; 1526-7598
• DOI: 10.1213/00000539-198801000-00011

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 +/- 21 seconds (mean +/- SE) to 572 +/- 41 seconds (P less than 0.05). There was no significant correlation between the plasma antithrombin III 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 less than 400 seconds after administration of 350 unit/kg heparin) did not prolong the ACT to greater than 400 seconds. These observations suggest that infusion of FFP will further prolong the ACT after heparin administration in most patients including some with initial heparin resistance.