Verification of the qLabs international normalized ratio point-of-care device for monitoring of patients attending an anticoagulation clinic

2018 ◽  
Vol 40 (5) ◽  
pp. 508-514 ◽  
Author(s):  
N. Mbokota ◽  
E. Schapkaitz ◽  
S. Louw
Keyword(s):  
Point Of Care ◽  
International Normalized Ratio ◽  
Anticoagulation Clinic

Warfarin Patients With Anemia Show Trend of Out-of-Range International Normalized Ratio Frequency With Point-of-Care Testing in an Anticoagulation Clinic

2018 ◽  
Vol 32 (5) ◽  
pp. 499-502 ◽  
Author(s):  
Christina E. DeRemer ◽  
Bliss McMichael ◽  
Henry N. Young
Keyword(s):  
Regression Model ◽  
Medical Center ◽  
Point Of Care ◽  
Academic Medical Center ◽  
International Normalized Ratio ◽  
Primary Objective ◽  
Anticoagulation Clinic ◽  
Care Practice ◽  
Study Results ◽  
The Impact

Introduction: Many factors influence international normalized ratio (INR); however, few studies have examined the impact of anemia in warfarin patients. The primary objective of this study was to explore the relationship between in-clinic anemia and the control of INR within an anticoagulation clinic. Methods: A retrospective chart review was performed on a random sample of patients seen in an academic medical center pharmacy-managed anticoagulation clinic. Hemochron® Signature Elite machine was utilized to monitor point-of-care (POC) INR. In-clinic anemia was defined as hematocrit <32%. Statistical analyses were conducted using STATA MP a webbased platform ( https://www.stata.com/statamp/ ). Results: Of the 300 patients analyzed, 45 (15%) patients had in-clinic anemia. Patients with in-clinic anemia were more likely to be younger ( P < .05), female ( P < .05), and have a diagnosis of sickle cell disease or anemia ( P < .05). In the unadjusted logistic regression model, patients with in-clinic anemia were less likely to have an in-range INR ( OR: 0.52; 95% CI: 0.27-0.98). The adjusted regression model did not show significance. Conclusion: Study results suggest that in-clinic anemia may be more prevalent among younger, female patients prescribed warfarin, and patients diagnosed with in-clinic anemia may be a risk factor for out-of-range INR. Pharmacists practicing in anticoagulation clinics can incorporate this information into patient care practice in efforts to maintain optimal management.

International Normalized Ratio values in group versus individual appointments in a pharmacist-managed anticoagulation clinic

2009 ◽  
Vol 66 (13) ◽  
pp. 1218-1223 ◽  
Author(s):  
Brooke L. Griffin ◽  
Jill S. Burkiewicz ◽  
Laura R. Peppers ◽  
Terri L. Warholak
Keyword(s):  
Group Versus ◽  
International Normalized Ratio ◽  
Anticoagulation Clinic

Importance of Device Evaluation for Point-of-Care Prothrombin Time International Normalized Ratio Testing Programs

2005 ◽  
Vol 80 (2) ◽  
pp. 181-186 ◽  
Author(s):  
Robert D. McBane ◽  
Cindy L. Felty ◽  
Mindy L. Hartgers ◽  
Rajeev Chaudhry ◽  
Lisa K. Beyer ◽  
...  
Keyword(s):  
Prothrombin Time ◽  
Point Of Care ◽  
International Normalized Ratio

Thromboelastometry as an Alternative Method for Coagulation Assessment in Pediatric Patients Undergoing Invasive Procedures: A Pilot Study

2018 ◽  
Vol 29 (03) ◽  
pp. 298-301
Author(s):  
Miroslav Durila ◽  
Jakub Jonas ◽  
Marianna Durilova ◽  
Michal Rygl ◽  
Jiri Skrivan ◽  
...  
Keyword(s):  
Whole Blood ◽  
Pediatric Patients ◽  
Point Of Care ◽  
Venous Catheter ◽  
International Normalized Ratio ◽  
Fresh Frozen Plasma ◽  
Severe Bleeding ◽  
Invasive Procedures ◽  
Coagulation Profile ◽  
Alternative Method

Introduction Standard coagulation tests (activated partial thromboplastin time [aPTT] and prothrombin time [PT]) are used for the assessment of coagulation profile in critically ill pediatric patients undergoing invasive interventions such as insertion of central venous catheter, tonsillectomy, laparotomy, etc. However, these tests do not reflect the profile of whole blood coagulation. Rotational thromboelastometry (ROTEM) as a point of care (POC) viscoelastic test may serve as an alternative method. Due to its ability to assess coagulation profile of the whole blood, it might yield normal results despite prolonged aPTT/PT results. The aim of this study was to find out if there was any severe bleeding during or after invasive procedures if ROTEM test was normal despite prolonged values of aPTT/PT in pediatric patients. Materials and Methods We retrospectively analyzed data for the years 2015 to 2017 for pediatric patients with prolonged values of aPTT or PT and normal ROTEM tests—internal thromboelastometry (INTEM) (assessing internal pathway of coagulation) and external thromboelastometry (EXTEM) (assessing external pathway of coagulation)—and we looked for severe bleeding during or after invasive procedures. Results In 26 pediatric patients (children from 2 months to 17 years old), we found that INTEM and EXTEM tests showed normal coagulation despite prolonged values of aPTT ratio with a median of 1.47 (minimum 1.04 and maximum 2.05), international normalized ratio with a median of 1.4 (minimum 0.99 and maximum 2.10), and PT ratio with a median of 1.30 (minimum 0.89 and maximum 2.11). In these patients, no severe bleeding was observed during interventions or postoperatively. Conclusion Our data support using thromboelastometry method as an alternative coagulation test for the assessment of coagulation profile in pediatric patients undergoing surgical or other invasive procedures, especially using it as a POC test. All invasive procedures in our study were performed without severe bleeding despite prolonged values of PT/aPTT with normal ROTEM results. It seems that ROTEM assessment of coagulation may lead to decreased administration of fresh frozen plasma and shorten time of patient preparation for intervention.

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