Sonoclot Analyzer, ACT Machine India, Thromboelastography, Cardiac Surgery, Liver Transplant

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Background: Pediatric cardiac surgery patients are at high risk for bleeding, and the antifibrinolytic drug tranexamic acid (TA) is often used to reduce blood loss. However, dosing schemes remain empirical as a consequence of the absence of pharmacokinetic study in this population. The authors’ objectives were thus to investigate the population pharmacokinetics of TA in pediatric cardiac surgery patients during cardiopulmonary bypass (CPB).   Methods: Twenty-one patients were randomized to receive TA either continuously (10 mg/kg followed by an infusion of 1 mg·kg −1 ·h −1  throughout the operation, and 10 mg/kg into the CPB) or discontinuously (10 mg/kg, then 10 mg/kg into the CPB and 10 mg·kg −1 ·h −1  at the end of CPB). Serum concentrations were measured at eight time points with chromatography–mass spectrometry and the data were modeled using Monolix (Lixoft, Orsay, France).  Results: Tranexamic acid pharmacokinetics was ascribed to a two-compartment open m...

Sonoclot (SC1) ACT Machine incorporates Sonoclot's Proprietary Visco-Elastic technology and is extremely sensitive to the developing clot. Normal ACT Machines mechanically detect mature clot to report Activated Clotting Time which takes into account cumulative activity of Factors, Fibrin gel & Platelets to form a mature clot. On the other hand Sonoclot ACT Machine starts monitoring the viscosity changes, which is the first component to change when the coagulation cascade is triggered by the respective activators. Factor Xa triggers Prothrombin to Thrombin (Factor IIa) the sample is still in the liquid phase. As Thrombin forms it triggers Fibrinogen to Fibrin Polymerization the sample starts to gel and the viscosity starts increasing. Sonoclot ACT Machine is very sensitive to this changing viscosity and first reports ACT, which is a function of Factor Xa activity. Once the ACT re...