154 - Coagulation Point of Care Testing systems

Autor(s): D. Giavarina

Issue: RIMeL - IJLaM, Vol. 5, N. 2, 2009 (MAF Servizi srl ed.)

Page(s): 154-159

The Near Patient Testing for coagulation tests started at the end of ’70 years, related to specific clinical necessities, as high anticoagulation in extra body circulation. These applications have now consolidated and the monitoring heparin anticoagulation and neutralization is strongly recommended in the cardiac surgery arena. Some of these tests are not even available by the central Lab. New tests, always for specific clinical conditions, are now implementing for inpatients. The expanding indications for warfarin therapy has generated increased concern over the process of warfarin monitoring and POCT is became a possible solution. Portable coagulometers are small portable units capable of measuring PT on a drop of whole blood. They could reduce the workload of the labs and improve the patient management and satisfaction. There are many instruments for coagulation POCT, and some of these for the direct use by the patients. The analytical results obtained by POCT instruments agree enough with the results obtained by the conventional coagulometers, especially if compared in clinical outcome. There are many evidences the number of adverse events during the oral anticoagulant therapy self monitored or self managed is similar or lower than those obtained by conventional monitoring. Conclusion: PT-INR self-testing by using POCT instruments may be considered as a suitable alternative to conventional laboratory testing. Training of patients or users, and implementation of appropriate quality assessment schemes are also essential prerequisites for the success of PT-INR self-testing, a specific role for clinical laboratories. Key-words: coagulation tests, oral anticoagulant, point-of-care testing, coagulometers, anticoagulation clinic.

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