Consideration of different POC test systems is emphasized in American College of Cardiology/American Heart Association Percutaneous Coronary Intervention guideline, which recommends use of different target ACT values on the basis of the device type ( 13).
#POC ISTAT KIM ACTIVATOR#
ACT measurements can vary depending on the type of POC test system used, including different manufacturers (or the same) the source of formula of the activator the amount of activator relative to sample volume or the method of clot detection ( 3, 5– 12).
Variations in response to heparin therapy can be related to its pharmacology, the patient, methods for monitoring therapeutic effect, or some combination of the above factors ( 4). The target level of heparin anticoagulation can vary significantly depending on the clinical procedure, necessitating a wide ACT analytical measuring range ( 3). Similar to partial thromboplastin time, ACT results reflect the time of clot formation via the intrinsic coagulation pathway by the addition of factor XII activators (e.g., Celite, kaolin, glass beads, ellagic acid) and increase linearly in relation to the heparin concentration ( 2). Invasive or operative clinical procedures that use heparin therapy and ACT testing may include dialysis, cardiac catheterization and angiography, intraaortic balloon pumping, percutaneous coronary intervention, extracorporeal membrane oxygenation, vascular surgery, valve replacements, and others. Education of health-care professionals is needed regarding differences in measured ACT values if changing or interchanging ACT test systems.Īctivated clotting time (ACT) is a point-of-care (POC) coagulation test designed to monitor hemostasis in patients receiving heparin therapy in clinical situations in which intensive anticoagulation is required ( 1). The present study findings demonstrate differences in measured ACT values between 5 different POC ACT methods and the effect analytical variables have on ACT test performance. Measurement of ACT is particularly useful during interventional clinical procedures involving use of heparin therapy to facilitate rapid decision-making for management of patient hemostasis.
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