Chapter 4: Heparin Management in Cardiopulmonary Bypass Surgery 4-3
Here are heparin dose response Signatures run using kaolin (kACT) and glass beads (gbACT+).
Below are heparin dose response graphs for both ACT and Clot Rate results for these Signatures.
Both ACT results show a linear relationship between the ACT result and the heparin concentration. The
kACT covers a heparin concentration range typical for high dosage heparin therapy while the gbACT+
covers a much smaller heparin range that only extends to about 1 IU/mL. The kACT results are appropriate
for managing high dose heparin therapy but are insensitive to small amounts of heparin. The kACT is a
poor test for detecting residual heparin. The gbACT+ test will be significantly prolonged for even small
amounts of residual heparin making it a preferred formulation for detecting residual heparin.
IMPORTANT: Do not use the gbACT+ test for high dosage heparin therapy.
Heparin-kACT
Minutes
0.0
5.0
10.0
15.0
20.0
Clot
Signal
0
25
50
75
100
125
Linearity Study
BB Citrated
6/9/2010
kACT
Group Description
Style Time Test Application Result Range Comment
0 1
2
3
4
5
Heparin (IU/mL whole blood)
Heparin Dose Response
using kACT
Heparin-gbACT+
Minutes
0.0
5.0
10.0
15.0
20.0
25.0
30.0
Clot
Signal
0
25
50
75
100
125
Group Description
Style Time Test Application Result Range Comment
0.0
0.2 0.3
0.4 0.5
0.6
0.8
0.1
Heparin (IU/mL whole blood)
Heparin Dose Response
using gbACT+
Heparin-kACT
Minutes
0.0
5.0
10.0
15.0
20.0
Clot
Signal
0
25
50
75
100
125
Linearity Study
BB Citrated
6/9/2010
kACT
Group Description
Style Time Test Application Result Range Comment
0 1
2
3
4
5
Heparin (IU/mL whole blood)
Heparin Dose Response
using kACT
Heparin-gbACT+
Minutes
0.0
5.0
10.0
15.0
20.0
25.0
30.0
Clot
Signal
0
25
50
75
100
125
Group Description
Style Time Test Application Result Range Comment
0.0
0.2 0.3
0.4 0.5
0.6
0.8
0.1
Heparin (IU/mL whole blood)
Heparin Dose Response
using gbACT+
Heparin-kACT
Minutes
0.0
5.0
10.0
15.0
20.0
Clot
Signal
0
25
50
75
100
125
Linearity Study
BB Citrated
6/9/2010
kACT
Group Description
Style Time Test Application Result Range Comment
Sonoclot Signature versus
Heparin Concentration
0
5
10
15
20
25
30
35
0
1
2
3
4
5
Clot Rate versus Heparin Concentration
Clot Rate (
∆Clot Signal/
∆minutes)
Heparin Concentration (IU/mL whole blood)
0
5
10
15
20
25
0
0.2
0.4
0.6
0.8
Clot Rate versus Heparin Concentration
Clot Rate (
∆Clot Signal/
∆minutes)
Heparin Concentration (IU/mL whole blood)
gbACT+
0
5
10
15
20
25
30
35
0
1
2
3
4
5
6
Clot Rate versus Heparin Concentration
Clot Rate (
∆Clot Signal/
∆minutes)
Heparin Concentration (IU/mL whole blood)
kACT
kACT
gbACT+
100
200
300
400
500
600
700
800
0
1
2
3
4
5
ACT versus Heparin Concentration
ACT (seconds)
Heparin Concentration (IU/mL whole blood)
kACT
gbACT+
0
100
200
300
400
500
600
0
0.2
0.4
0.6
0.8
ACT versus Heparin Concentration
ACT (seconds)
Heparin Concentration (IU/mL whole blood)
Heparin-gbACT+
Minutes
0.0
5.0
10.0
15.0
20.0
25.0
30.0
Clot
Signal
0
25
50
75
100
125
Group Description
Style Time Test Application Result Range Comment
0
100
200
300
400
500
600
700
800
0
1
2
3
4
5
6
ACT versus Heparin Concentration
ACT (seconds)
Heparin Concentration (IU/mL whole blood)
kACT
gbACT+
Heparin-kACT
Minutes
0.0
5.0
10.0
15.0
20.0
Clot
Signal
0
25
50
75
100
125
Linearity Study
BB Citrated
6/9/2010
kACT
Group Description
Style Time Test Application Result Range Comment
Sonoclot Signature versus
Heparin Concentration
0
5
10
15
20
25
30
35
0
1
2
3
4
5
Clot Rate versus Heparin Concentration
Clot Rate (
∆Clot Signal/
∆minutes)
Heparin Concentration (IU/mL whole blood)
0
5
10
15
20
25
0
0.2
0.4
0.6
0.8
Clot Rate versus Heparin Concentration
Clot Rate (
∆Clot Signal/
∆minutes)
Heparin Concentration (IU/mL whole blood)
gbACT+
0
5
10
15
20
25
30
35
0
1
2
3
4
5
6
Clot Rate versus Heparin Concentration
Clot Rate (
∆Clot Signal/
∆minutes)
Heparin Concentration (IU/mL whole blood)
kACT
kACT
gbACT+
100
200
300
400
500
600
700
800
0
1
2
3
4
5
ACT versus Heparin Concentration
ACT (seconds)
Heparin Concentration (IU/mL whole blood)
kACT
gbACT+
0
100
200
300
400
500
600
0
0.2
0.4
0.6
0.8
ACT versus Heparin Concentration
ACT (seconds)
Heparin Concentration (IU/mL whole blood)
Heparin-gbACT+
Minutes
0.0
5.0
10.0
15.0
20.0
25.0
30.0
Clot
Signal
0
25
50
75
100
125
Group Description
Style Time Test Application Result Range Comment
0
100
200
300
400
500
600
700
800
0
1
2
3
4
5
6
ACT versus Heparin Concentration
ACT (seconds)
Heparin Concentration (IU/mL whole blood)
kACT
gbACT+
