Point-of-care prothrombin time testing in paediatric intensive care

Urwyler, Natalie; Staub, Eveline; Staub, Lukas; Daetwyler, Karin; Fluri, Simon; Sollberger, Tanja; Theiler, Lorenz; Greif, Robert

doi:10.1097/eja.0b013e32834b7d65

Cited by 9 publications

(2 citation statements)

References 17 publications

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“…The failure rate of measuring INRs by the CoaguChek XS was 2% in our study. A previous study in a pediatric population demonstrated that failure rates were 2% with CoaguChek XS and 4% in the laboratory test [22]. One limitation of this study is that CoaguChek XS INR was measured by a small group of trained neonatologists.…”

Section: Discussionmentioning

confidence: 94%

International normalized ratio testing with point-of-care coagulometer in healthy term neonates

et al. 2014

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BackgroundNeonates routinely receive vitamin K to prevent vitamin K deficiency bleeding, which is associated with a high mortality rate and a high frequency of neurological sequelae. A coagulation screening test might be necessary to detect prophylactic failure or incomplete prophylaxis. However, venous access and the volume of blood required for such testing can be problematic. CoaguChek XS is a portable device designed to monitor prothrombin time while only drawing a small volume of blood. Although the device is used in adults and children, studies have not been performed to evaluate its clinical utility in neonates, and the reference value is unknown in this population. The objectives of the present study were to determine the reference intervals (RIs) for international normalized ratio (INR) using the CoaguChek XS by capillary puncture in healthy term neonates, to evaluate factors that correlate with INR, and to evaluate the device by assessing its ease of use in clinical practice.MethodsThis study included 488 healthy term neonates born at a perinatal center between July 2012 and June 2013. The INRs determined by CoaguChek XS were measured in 4-day-old neonates.ResultsThe enrolled neonates were orally administered vitamin K 6-12 h after birth. A RI for INRs in 4-day-old neonates was established using the CoaguChek XS with a median value of 1.10 and a range of 0.90–1.30. A significant difference in the INR was noted between male (median value, 1.10; RI, 0.90–1.30) and female (median value, 1.10; RI, 0.90–1.24) neonates (p = 0.049). The INR was found to correlate with gestational age, birth weight, and hematocrit value.ConclusionsThe CoaguChek XS device is safe, fast, and convenient for performing INR assays in neonates. Our study is the first to establish a RI for INRs that were measured using the CoaguChek XS in healthy term neonates.

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Section: Discussionmentioning

confidence: 94%

International normalized ratio testing with point-of-care coagulometer in healthy term neonates

et al. 2014

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“…Several studies have evaluated the clinical use of the CoaguChek XS Plus system [10, 13–17]. Those studies were performed in different clinical settings using different laboratory-based tests, and only one of them compared the CoaguChek XS Plus system with the Stago coagulation system (Table 2).…”

Section: Discussionmentioning

confidence: 99%

Comparison of International Normalized Ratio Measurement between CoaguChek XS Plus and STA-R Coagulation Analyzers

Hur

Kim

Park

et al. 2013

BioMed Research International

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Background. Point-of-care testing (POCT) coagulometers are increasingly being used in the hospital setting. We investigated whether the prothrombin time international normalized ratio (INR) results by CoaguChek XS Plus (Roche Diagnostics GmbH, Mannheim, Germany) can be used reliably without being confirmed with the INR results by STA-R system (Diagnostica Stago S.A.S, Asnières sur Seine, France). Methods. A total of 118 INR measurements by CoaguChek XS Plus and STA-R were compared using Passing/Bablok regression analysis and Bland-Altman plot. Agreement of the INR measurements was further assessed in relation to dosing decision. Results. The correlation of INR measurements between CoaguChek XS Plus and STA-R was excellent (correlation coefficient = 0.964). The mean difference tended to increase as INR results increased and was 0.25 INR in the therapeutic range (2.0-3.0 INR). The overall agreement was fair to good (kappa = 0.679), and 21/118 (17.8%) INR measurements showed a difference in dosing decision. Conclusion. The positive bias of CoaguChek XS Plus may be obvious even in the therapeutic INR range, and dosing decision based on the CoaguChek XS Plus INR results would be different from that based on the STA-R results. The INR measurements by POCT coagulometers still need to be confirmed with the laboratory INR measurements.

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Comparison of Prothrombin Time Derived From CoaguChek XS and Laboratory Test According to Fibrinogen Level

Kim

Lee

Park

et al. 2014

Clinical Laboratory Analysis

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Background: CoaguChek XS is one of the most widely used point-of-care (POC) devices to evaluate prothrombin time for monitoring oral anticoagulant therapy. Unlike laboratory methods, it detects electrical signals produced by thrombin activity to derive the international normalized ratio (INR). Therefore, we hypothesized that laboratory methods and CoaguChek XS could produce different results according to fibrinogen level. Methods: We compared INR values obtained from the CoaguChek XS and conventional laboratory method with 91 plasma samples covering a wide range of fibrinogen levels. Results: The samples were stratified into low, mid, and high fibrinogen groups by fibrinogen levels of <130 mg/dl, 130-450 mg/dl, and >450 mg/dl, respectively.

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Point-of-care prothrombin time testing in paediatric intensive care

Cited by 9 publications

References 17 publications

International normalized ratio testing with point-of-care coagulometer in healthy term neonates

International normalized ratio testing with point-of-care coagulometer in healthy term neonates

Comparison of International Normalized Ratio Measurement between CoaguChek XS Plus and STA-R Coagulation Analyzers

Comparison of Prothrombin Time Derived From CoaguChek XS and Laboratory Test According to Fibrinogen Level

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