Anesthesia Technologist Practice Exam

During cardiopulmonary bypass, what is the target ACT range for heparin titration?

1. 100 - 200 seconds

2. 300 - 400 seconds

3. 400 - 500 seconds

4. 500 - 600 seconds

The correct answer is: 400 - 500 seconds

The target ACT (Activated Clotting Time) range for heparin titration during cardiopulmonary bypass is generally set between 400 and 500 seconds. This range ensures adequate anticoagulation is achieved to prevent clot formation within the bypass circuit while minimizing the risk of excessive bleeding during and after the procedure. Heparin acts as an anticoagulant by inhibiting thrombin and factor Xa, which are crucial for the clotting cascade. Monitoring the ACT helps to determine if enough heparin has been administered to maintain a state of hemostatic balance throughout the surgical procedure. The chosen target range reflects a consensus in clinical practice that optimizes patient safety and procedural effectiveness. Lower ranges, like 100-200 seconds or 300-400 seconds, might not provide sufficient anticoagulation for the circuit, leading to thrombus formation. Conversely, excessively high ranges such as 500-600 seconds may increase the risk of bleeding complications. Thus, the emphasized range of 400-500 seconds is crucial for effective management during cardiopulmonary bypass procedures.