Chema Nieto Castañón Feb 22, 2019:

I think Anne is on the right track but there are two different ACT values in this case. I'd say those are pre and post surgical [complication] values of ACT (valor inicial y valor final de ACT), which also explains the treatment given after that final value (first ACT value is about normal while second one is too low).

Anne Schulz Feb 22, 2019:

The reference just seems to say that if a patient is on heparin, ACT normal range is 180–240 sec; for patients not on heparin, it is 70–120 sec. It does not say (IMO) that ACT is measured both with and without heparin in the lab, resulting in two different values. <br />Heparin is used for hemodialysis to keep the shunt open and prevent formation of blood clots in the system. My interpretation would therefore be that ACTi was measured "intra"-hemodialysis, and ACTf was measured at the end ("final") of hemodialysis, and found to have returned to normal then, consistent with the relatively short half life of heparin. Chronically, this patient seems to be on anticoagulant dabigatran, for which the specific antidote idarucizumab plus fibrinogen were then administered in order to avoid a bleeding risk when operating on the patient.

Neil Ashby (asker) Feb 22, 2019:

Hi Liz, did you check out the reference I provided in the question? Given the values in my text, it could be something to do with "activated clotting time" with/without heparin.

liz askew Feb 22, 2019:

no idea about
i
and
f

liz askew Feb 22, 2019:

although, here:
www.revespcardiol.org/es/anticoagulacion-durante-el.../1309...
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by I Lozano - ‎2006 - ‎Related articles
La heparina no fraccionada (HNF) sirve como terapia anticoagulante desde el ... Su mayor actividad anticoagulante proviene de una única secuencia ... Para su control se utiliza el ACT (activated clotting time), ya que el TTP ..... 1998;82:L19-24. .... Miocardiopatías e insuficiencia cardiaca (170); Cardiopatía isquémica (239) ..

liz askew Feb 22, 2019:

quick finding
ACT = agua corporal total