A Novel Whole Blood Capillary Technic for Measuring the Prothrombin Time

Lucas, Fred V.; Duncan, Alexander; Jay, Richard; Coleman, Robert W.; Craft, Paula; Chan, Beatrice; Winfrey, Laura; Mungall, Dennis; Hirsh, Jack

doi:10.1093/ajcp/88.4.442

Cited by 93 publications

(32 citation statements)

References 7 publications

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“…Point-of-care PT monitoring first became available for professional use in doctor's offices and hospitals in the late 1980s after Lucas et al [22] (Table I).…”

Section: Home Pt-inr Monitoring Instrumentsmentioning

confidence: 99%

Home prothrombin time monitoring: A literature analysis

2004

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The anticoagulant activity of warfarin sodium is monitored by the prothrombin time (PT) using the international normalized ratio (INR). Standard oral anticoagulant therapy monitoring requires frequent patient visits to physicians' offices and/or laboratories to optimize warfarin dosage. Home PT monitoring by patients can increase testing frequency and may thus decrease complications associated with oral anticoagulant therapy. Clinical studies suggest that home PT monitoring is more effective than uncoordinated management and is as effective as care through specialized anticoagulation clinics for keeping INRs within a therapeutic range. There are accurate and reliable instruments available, but paramount to the success of home PT monitoring is sound patient selection, appropriate patient training, and consistent quality control. Am.

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“…Point-of-care PT monitoring first became available for professional use in doctor's offices and hospitals in the late 1980s after Lucas et al [22] (Table I).…”

Section: Home Pt-inr Monitoring Instrumentsmentioning

confidence: 99%

Home prothrombin time monitoring: A literature analysis

2004

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“…15 The instrument uses a laser photodetector pair to monitor the interval between application of the blood sample and cessation of its flow. Clotting time results are reported in seconds.…”

Section: Analyzersmentioning

confidence: 99%

The Diagnostic Accuracy of Bedside and Laboratory Coagulation:Procedures Used To Monitor the Anticoagulation Status of Patients Treated With Heparin

Solomon¹,

Mullins²,

Lyden

et al. 1998

Am J Clin Pathol

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We evaluated the diagnostic accuracy of three bedside coagulation procedures, the Hemochron activated whole-blood clotting time (ACT) (International Technidyne, Edison, NJ), the CoaguChek Plus (Boehringer Mannheim, Indianapolis, Ind) activated partial thromboplastin time (APTT) and the TAS (Cardiovascular Diagnostics, Raleigh, NO APTT, before removal of arterial sheaths, in patients who received heparin therapy during percutaneous coronary angioplasty. As part of the postprocedure care, nurses performed bedside coagulation tests, removed the sheaths when appropriate coagulation criteria were met, and collected samples for laboratory APTT determinations and heparin assays performed with an automated chromogenic anti-Xa assay. Patients with heparin concentrations of 0.3 U/mL or more were classified as anticoagulated and those with concentrations less than 0.3 U/mL, as not anticoagulated. Analysis of the receiver operator characteristic (ROC) curve was used to rank the performance of the methods. Areas under the ROC curves ± SE for the laboratory APTT, CoaguChek Plus APTT, Hemochron ACT, and TAS APTT were 0.978 ± 0.016, 0.872 ± 0.044, 0.797 ± 0.039, and 0.795 ± 0.048, respectively. At cutoff values for the tests that provide greatest safety for the patients (no false-negative results), the false-positive rates for the laboratory, CoaguChek Plus, Hemochron, and TAS methods were 15%, 27%, 62%, and 100%, respectively. The laboratory APTT demonstrated the highest diagnostic accuracy in this application; however, turnaround rime for the test (50% of the results were reported in excess of 77 minutes) was inadequate for clinical decision making. To meet this requirement, we developed a point-of-care program using the whole blood APTT performed on the CoaguChek Plus analyzer.

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“…9 Briefly, a drop of whole blood is collected by fingerstick performed with an automated device (Autolet, Ulster Scientific, Highland, NY). The blood sample is dropped into a reservoir in a plastic cartridge that has been inserted into the monitor.…”

Section: Portable Prothrombin Time Monitormentioning

confidence: 99%