• Yue Dong, Gregory A Nuttall, William C Oliver, Shvetank Agarwal, and Mark H Ereth.
• Transfusion, Coagulation and Cardiopulmonary Bypass Research Group, Department of Anesthesiology, Mayo Clinic College of Medicine Rochester, MN 55905, USA.
• J Clin Anesth. 2007 Sep 1;19(6):424-8.

Study ObjectiveTo determine whether a new Sonoclot-based, aprotinin-insensitive activated clotting time (aiACT) assay yields stable results over a broad range of aprotinin concentrations.DesignProspective trial conducted on in vitro blood samples.SettingTertiary-care teaching medical center.Participants19 healthy adult volunteers.InterventionsWhole blood samples were collected from volunteers. Heparin (2 U/mL) and escalating concentrations of aprotinin of 160 to 500 kallikrein inhibitory units (KIU)/mL were added in vitro.Measurements And Main ResultsCelite ACT, kaolin ACT, and aiACT assays were completed. The aiACT showed stable activated clotting time (ACT) results on heparinized, noncitrated blood with added aprotinin (P = nonsignificant). In contrast, celite ACT and kaolin ACT were greatly prolonged when aprotinin was added to heparinized, noncitrated, and citrated blood (P < 0.05). The aiACT had consistent results at all aprotinin concentrations (P = nonsignificant).ConclusionsAprotinin (160, 320, and 500 KIU/mL) significantly prolongs the ACT value with celite and kaolin activators but not with the aprotinin-insensitive activator.

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