Transitioning away from Medtronic HMS for CABG cases

We transitioned from the HMS to the iSTAT earlier this year.  We had already moved to the iSTAT for ACT in other departments and had included the CVOR in the initial validation, so the validation was already complete.  The protamine dosing can be calculated by the perfusionists instead of by the HMS.  From what I could tell in the guidelines referenced, it says Heparin reversal management strategy should aim to limit over-exposure to protamine and should be confirmed by ACT and/or heparin/protamine titration. So ACT alone should meet the standard.  I know that our perfusionists record the baseline ACT prior to administering heparin and record a final ACT after administration of protamine to indicate reversal of the heparin to an acceptable baseline level. We have not had any requests for additional testing from our perfusionists or the CVOR.

We transitioned from HMS Plus to Hemochron 100s in 5/2025. The CVOR is now using the ACT + cartridge only in their cases and have had no issues or requests for additional testing. The perfusionists determine the protamine dose themselves based on a standard calculation they use. Overall the perfusionist and myself are very happy with this instrument change.