Cardiothoracic & vascular anesthesia
Activated Clotting Time Measured by Hemochron Signature Elite in Adult Cardiac Surgery: Implications for Clinical Practice
Main finding · Concordance ACTe vs ACTrResult — go to the resultBland-Altman mean bias −20.7% 95% CI −75.28% to +35.5%Authors' conclusion
ACTe and ACTr showed no correlation. Switching devices without adjusting ACT thresholds leads to unnecessary UFH redosing, despite adequate anticoagulation as measured by anti-Xa levels.
Study context
- Population
- Elective adult cardiac surgery patients receiving 300 IU/kg unfractionated heparin (UFH) before cardiopulmonary bypass (CPB), university hospitals
- Participants
- 35 patients
- Exposure
- ACTe vs ACTr
- Outcome
- Concordance ACTe vs ACTr
Methodological detailsmulticentre, method-comparison
- Multicentre
- Method-comparison
Main finding
As reported in the abstract
Bland-Altman mean bias
−20.7%
95% CI −75.28% to +35.5%
- Pearson correlation ACTe vs ACTr (no correlation)
- r = 0.157, p = 0.369
- Linear regression, limited agreement
- R2 = 0.025
- Predicted ACTe corresponding to ACTr threshold of 450 seconds
- 357 seconds
Observational data: associations, not effects.
Further findings
UFH redosing
- Second dose after 300 IU/kg: ACTe <450 s despite ACTr ≥450 s
- 13 (37%)
- Second dose after 300 IU/kg: ACT <450 s with both devices
- 5 (14%)
- After second dose, target ACTe not reached despite ACTr ≥450 s (third dose required)
- 10/18 (55%)
Anti-Xa vs ACTe
- Positive correlation anti-Xa vs ACTe
- r = 0.587, p < 0.001
- Predicted ACTe interval for anti-Xa 4 IU/mL
- 263 to 515 seconds
- Anti-Xa always >4 IU/mL (adequate anticoagulation in all cases)
Parts of this Brief are withheld: the automatic checks could not confirm them against the abstract.
Original publication
Activated Clotting Time Measured by Hemochron Signature Elite in Adult Cardiac Surgery: Implications for Clinical Practice. J Cardiothorac Vasc Anesth. Published 18 May 2025. doi:10.
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