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

scholarly journals Point-of-care coagulation testing for reducing in-hospital delay in thrombolysis

2018 ◽  
Vol 26 (4) ◽  
pp. 218-224 ◽  
Author(s):  
Jung Hee Han ◽  
Seongsoo Jang ◽  
Mi-Ok Choi ◽  
Mi-Jeong Yoon ◽  
Seung-Bok Lim ◽  
...  
Keyword(s):  
Ischemic Stroke ◽  
Prothrombin Time ◽  
Laboratory Testing ◽  
Point Of Care ◽  
Intravenous Thrombolysis ◽  
International Normalized Ratio ◽  
Interquartile Range ◽  
Time Interval ◽  
Central Laboratory ◽  
Point Of Care Testing

Background: The confirmation of prothrombin time international normalized ratio by a central laboratory often delays intravenous thrombolysis in patients with acute ischemic stroke. Objectives: We investigated the feasibility, reliability, and usefulness of point-of-care determination of prothrombin time international normalized ratio for stroke thrombolysis. Methods: Among 312 patients with ischemic stroke, 202 who arrived at the emergency room within 4.5 h of stroke onset were enrolled in the study. Patients with lost orders for point-of-care testing for the prothrombin time international normalized ratio or central laboratory testing for the prothrombin time international normalized ratio (n = 47) were excluded. We compared international normalized ratio values and the time interval from arrival to the report of test results (door-to-international normalized ratio time) between point-of-care testing for the prothrombin time international normalized ratio and central laboratory testing for the prothrombin time international normalized ratio. In patients who underwent thrombolysis, we compared the time interval from arrival to thrombolysis (door-to-needle time) between the current study population and historic cohort at our center. Results: In the 155 patients included in the study, the median door-to-international normalized ratio time was 9.0 min (interquartile range, 5.0–12.0 min) for point-of-care testing for the prothrombin time international normalized ratio and 46.0 min (interquartile range, 38.0–55.0 min) for central laboratory testing for the prothrombin time international normalized ratio (p < 0.001). The intraclass correlation coefficient between point-of-care testing for the prothrombin time international normalized ratio and central laboratory testing for the prothrombin time international normalized ratio was 0.975 (95% confidence interval: 0.966–0.982). Forty-nine of the 155 patients underwent intravenous thrombolysis. The door-to-needle time was significantly decreased after implementation of point-of-care testing for the prothrombin time international normalized ratio (median, 23.0 min; interquartile range, 16.0–29.8 vs median, 46.0 min; interquartile range, 33.5–50.5 min). Conclusion: Utilization of point-of-care testing for the prothrombin time international normalized ratio was feasible in the management of patients with acute ischemic stroke. Point-of-care testing for the prothrombin time international normalized ratio was quick and reliable and had a pivotal role in expediting thrombolysis.

European Concerted Action on Anticoagulation (ECAA): International Normalized Ratio Variability of CoaguChek and TAS Point-of-Care Testing Whole Blood Prothrombin Time Monitors

2002 ◽  
Vol 88 (12) ◽  
pp. 992-995 ◽  
Author(s):  
M. Keown ◽  
N. Chauhan ◽  
C. Shiach ◽  
A. M. H. P. van den Besselaar ◽  
A. Tripodi ◽  
...  
Keyword(s):  
Prothrombin Time ◽  
Whole Blood ◽  
Point Of Care ◽  
International Normalized Ratio ◽  
Operator Technique ◽  
Concerted Action ◽  
Point Of Care Testing ◽  
Blood Samples ◽  
International Normalised Ratio ◽  
Whole Blood Samples

SummaryThe object was to assess the variability in displayed International Normalised Ratio (INR) between monitors of the same manufacture using whole blood samples from the same subjects. Two brands of monitor, CoaguChek Mini and the TAS PT-NC were tested.14 instruments of each brand were tested on the same day at the same laboratory by the same operator using identical blood samples to avoid between-centre differences in samples and operator technique. Whole blood samples from two normal donors and four coumarintreated patients were tested to assess between-instrument variability of INR.Results have been coded. There was a much wider dispersion of INR on Brand B than on Brand A. One Brand A instrument failed to give a result with one of the two whole blood samples from one patient. One Brand B monitor gave an aberrant result with one of the samples from a normal subject.On both brands of monitor, INR variability appeared to be due mainly to duplication differences rather than between-instrument variability on both normal and coumarin whole blood samples.

Calibration of a Lyophilized Pooled Plasma as Candidate Reference Plasma for Standardization of the Prothrombin Time Ratio

1993 ◽  
Vol 13 (02) ◽  
pp. 96-105 ◽  
Author(s):  
H. Beeser ◽  
U. Becker ◽  
H. J. Kolde ◽  
E. Spanuth ◽  
P. Witt ◽  
...  
Keyword(s):  
Prothrombin Time ◽  
International Study ◽  
International Normalized Ratio ◽  
Measurement Methods ◽  
Factor V ◽  
Diagnostic Instruments ◽  
Plasma Pool ◽  
Normal Plasma ◽  
German Association ◽  
Prothrombin Time Ratio

SummaryThe prothrombin time (PT), obtained from a fresh normal plasma pool (FPP), is the basis both for the establishment of the 100% activity (normal plasma) and for the ratio calculation used in the International Normalized Ratio (INR) according to the recommendations of the ICSH/ICTH (6). Today the PT of lyophilized normal plasma pools are successfully used as reference for the assessment of samples in proficiency studies. However, a lack of comparability is to be recognized. Therefore the Committee of Hematology of the German Association of Diagnostics’ and Diagnostic Instruments’ Manufacturers (VDGH) decided to produce a candidate reference plasma (VDGH Reference Plasma) which was calibrated against fresh normal plasma pools in an international study.The basic calibration was performed by using the same certified BCR thromboplastin (BCT/099) by all participants. The endpoint was determined manually and by using the coagulometer Schnitger-Gross. In additional testings each participant used his own routine thromboplastins and methods. Calculating the ratio [PT VDGH Reference Plasma (sec)/PT fresh normal plasma pool (sec)] the VDGH Reference Plasma showed a deviation from the average fresh normal plasma pool of 1.05 both with the BCT/099 and with all thromboplastins. There were obtained some statistical differences between “plain” and “combined’’ (added factor V and fibrinogen) thromboplastins. No statistical difference was found between the different endpoint measurement methods (manual, mechanical, optical).In spite of these statistical deviations the VDGH Reference Plasma can be used for the standardization of the PT-normal (100%) value with different ratios for plain (1.06) and combined (1.02) thromboplastins. The manufacturers will use this VDGH Reference Plasma for the calibration of their commercially available calibration plasmas, which allows the user of such a material to calculate a calibrated 100% PT value.

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