Point-of-care test (POCT) INR: hope or illusion?

Dusse, Luci Maria Sant'Ana; Oliveira, Nataly Carvalho; Rios, Danyelle Romana Alves; Marcolino, Milena Soriano

doi:10.5935/1678-9741.20120047

Cited by 11 publications

(5 citation statements)

References 20 publications

(20 reference statements)

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“…To treat uremia caused by renal failure, hemodialysis is used more and more widely, and the advantages and disadvantages of various vascular pathways are more exposed to the vision of medical workers [ 5 , 14 ]. To carry out hemodialysis smoothly, it is particularly important for long-term dialysis patients to make individualized dialysis plans reasonably and establish and maintain good functional vascular accesses [ 15 ].…”

Section: Discussionmentioning

confidence: 99%

Analysis of Different Vascular Accesses on Dialysis Quality and Infection Risk Factors of Hemodialysis Patients

Zeng

et al. 2021

Evidence-Based Complementary and Alternative MedicineRetracted 2023-6-21

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Objective. To explore the influence of different vascular accesses on dialysis quality and infection risk factors of hemodialysis patients. Methods. A total of 162 patients with end-stage renal disease admitted to our hospital from February 2018 to July 2020 were divided into two groups: cuff tunnel conduit (CTC) group and native arteriovenous fistula (AVF) group. Peripheral blood was collected before and 6 months after dialysis. The incidence of vascular recirculation was measured, and the risk factors of infection were analyzed. Results. The levels of HB, Alb, CRP, BUN, Scr, and TP after dialysis in the two groups were lower than those before dialysis ( P < 0.05 ). The Kt/V of patients in both groups did not exceed 1.2, and the URR value exceeded 60%. The results of independent-samples T test analysis documented that the Kt/V level of patients in the AVF group was higher than that of those in the CTC group after dialysis ( P < 0.05 ). The results of the urea method revealed that 22 of 68 patients (32.35%) in the CVC group and 21 of 94 (22.34%) in the AVF group had vascular pathway recirculation. The χ2 test showed that there was no remarkable difference in the incidence of vascular pathway recirculation between both groups ( P > 0.05 ). However, the results of the nonurea method revealed that the incidence of vascular pathway recirculation in the AVF group was lower than that in the CVC group ( P < 0.05 ). Multivariate logistic regression was used to further analyze the factors with statistical significance in the single factor results. It showed that age >60 years, dialysis duration >1 year, dialysis times, diabetes, hypertension, and CTC were all independent risk factors causing vascular access infection. Conclusion. If all conditions permit, AVF hemodialysis is a better choice for patients with end-stage renal disease. For the elderly, long-term hemodialysis, and those with diabetes and hypertension, it is necessary to make detailed plans, strengthen the operation proficiency of CTC, and reduce the incidence of infection.

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“…Given that problems in INR-POCT determination may occur within the preanalytic phase as well as the analytic phase [ 21 ], we also investigated thrombocytes and hematocrit, which are known factors influencing INR measurement with POCT devices (cave at dehydration). The analysis of values exceeding the critical INR cut-off in our samples revealed that falsification might have happened in only one case.…”

Section: Discussionmentioning

confidence: 99%

Thrombolysis in stroke patients: Comparability of point-of-care versus central laboratory international normalized ratio

et al. 2018

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BackgroundIn acute stroke patients, thrombolysis is one gold standard therapy option within the first four hours after the ischemic event. A contraindication for thrombolysis is an International Normalized Ratio (INR) value >1.7. Since time is brain, rapid and reliable INR results are fundamental. Aim was to compare INR values determined by central laboratory (CL) analyzer and Point-of-Care Testing(POCT)-device and to evaluate the quality of POCT performance in cases of potential therapeutic thrombolysis at a certified stroke unit.MethodsIn 153 patients INR measurements using POCT-devices (HEMOCHRON Signature Elite®) were compared to INR measurements (BCS®XP) performed at the central laboratory. Outlier evaluation was performed regarding the critical thrombolysis cut-off.ResultsOverall, we demonstrated a significant correlation (r = 0.809, p<0.0001) between both measurement methods. Mean value of the absolute difference between CL-INR and POCT-INR measurements was 0.23. In 95.4% of these cases, no differences regarding the critical cut-off (INR 1.7) were observed. POCT-INR values tended to be higher than the CL-INR values (p = 0.01). In 4.6% cases, a different value regarding thrombolysis cut-off was found. All patients were >75 years.ConclusionsPOCT-INR measurements based on our POCT concept are suitable to determine INR values in critical stroke patients. Nevertheless, outlier evaluation is mandatory.

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“…Um importante recurso desenvolvido nas últimas décadas foi o chamado teste point of care (POC), também conhecidos no Brasil como testes laboratoriais rápidos ou exames a beira leito, como a ultrassonografia, os quais têm como principal objetivo a realização de diagnósticos de forma mais rápida e eficiente (Dusse, Oliveira, Rios & Marcolino, 2012).…”

Section: Introductionunclassified

As facilidades e contribuições da tecnologia point of care no ambiente hospitalar

Silva

Lago

Machado

et al. 2022

RSD

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O objetivo deste estudo foi destacar as vantagens e contribuições trazidas pelos exames point of care apontando os consensos sobre esta temática na atualidade. Foi realizada uma revisão de literatura, elaborada através de coleta de dados a partir de fontes secundárias, por meio de levantamento bibliográfico. A busca se deu por documentos primários, através da base de dados da Scielo, Biblioteca Virtual da Saúde (BVS) e PubMed. Como critério de inclusão delimitou-se o período de 2011 a 2021, aceitando-se publicações na íntegra ou somente seus resumos publicados. Foram aceitos somente artigos publicados nos idiomas português e inglês. Como descritores foram utilizados: point of care, tecnologia, diagnóstico. Através do levantamento bibliográfico realizado foi possível concluir que a tecnologia point of care é sobremodo importante, até mesmo essencial para que se possa determinar o diagnóstico definitivo e confirmatório de uma série de condições patológicas e clínicas no cotidiano do atendimento hospitalar, especialmente. Esta tecnologia deve ser cada vez mais estimulada na prática, tendo em vista não somente o fato de que permite um diagnóstico precoce, mas também porque possibilita um melhor prognóstico para aqueles casos considerados mais graves, contribuindo para que vidas sejam salvas.

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“…Thus, the technological and systematized tools at the service of health sciences must be analyzed and, because of their efficiency, must be put into practice in routine activities performed at the hospital level. An important resource developed in recent decades has been the development of so-called point-ofcare (POC) tests, whose main objective is to make diagnoses faster and more efficient (DUSSE et al, 2012).…”

Section: Introductionmentioning

confidence: 99%

Evaluation of the stability of anodic thin films on titanium in physiological environment

Gomes¹,

Bulhões²

2022

Relevant Studies Focused on Health Sciences

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“…Fibrinogen is proportional to the clotting time and is measured using calibration standards.Standard-bedside tests do not involve hematocrit effect in effi cacious plasma volume in measurements.Point of care testsPoint-of-care tests (sonoclot, thromboelastography[TEG] and rotational thromboelastometry[ROTEM]) can measure the viscoelastic properties of full-thickness clot allowing bedside assessment of the secondary hemostasis of blood clotting(10).Unlike standard tests, full screening can be provided faster with small volume of samples and give the true image of clot formation[17]. They can be used in cardiovascular surgery and liver operations besides trauma patients.Point-of-care tests, or otherwise bedside tests have beenshown to benefi t for rapid clinical decision-making and have been developed especially in the last decade[20]. These tests are particularly important because they can be performed close to the patient and provide information about the quality and dynamics of the clot[16].…”

mentioning

confidence: 99%

New methods for bleeding monitoring

Saracoglu¹

2018

Glob J Anesth

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Bleeding is a potentially preventable reason of the death among patients during major surgery. Appropriate monitorization is necessary to perform optimum resuscitation. However, conventional coagulation tests have some limitations. In recent years, point of care (POC) tests has been developed to improve patient safety in the presence of clinical bleeding POC tests measure viscoelastic properties of full-thickness clot formation in the beginning of bleeding. In this review, both of advantage and disadvantage of monitorization tests during bleeding management is explained.

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Point-of-care test (POCT) INR: hope or illusion?

Abstract: In the last decade, point-of-care tests were developed to provide rapid generation of test results. These tests have increasingly broad applications. In the area of hemostasis, the international normalized ratio, INR point-of-care test (POCT INR) Rev Bras Cir Cardiovasc 2012;27(2):296-301

Cited by 11 publications

References 20 publications

Analysis of Different Vascular Accesses on Dialysis Quality and Infection Risk Factors of Hemodialysis Patients

Thrombolysis in stroke patients: Comparability of point-of-care versus central laboratory international normalized ratio

As facilidades e contribuições da tecnologia point of care no ambiente hospitalar

Evaluation of the stability of anodic thin films on titanium in physiological environment

New methods for bleeding monitoring

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