Articles: prothrombin-time.
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Data on the performance of point-of-care (POC) or near-patient devices in the management of critically unwell patients are limited, meaning that there are demands for confirming POC test results in the routine clinical laboratory and so potentially leading to delay in treatment provision. We evaluated the performance of the i-STAT CHEM 8+ and CG4+, Hemochron Signature Elite, HemoCue Hb 201+ and WBC Diff Systems on whole blood collected from medical and surgical patients admitted to the intensive care unit at an Australian tertiary care hospital. Measurements obtained for haematology, coagulation, biochemistry and arterial blood gas parameters using POC devices were compared against clinical laboratory analysers (XE-5000, STA-R Evolution, Dimension Vista 1500 and ABL800 FLEX). ⋯ There was good correlation demonstrated for sodium, potassium, chloride, ionised calcium, glucose, urea, haemoglobin and haematocrit values (i-STAT Chem 8+); pH, pCO(2), bicarbonate and oxygen saturation (i-STAT CG4+); haemoglobin, white cell, neutrophil count and lymphocyte counts (Hemocue); and internationalised normal ratio (INR; Hemochron Signature Elite), but not creatinine, anion gap, pO(2), base excess, lactate, eosinophil count, prothrombin and activated partial thromboplastin time. POC devices were comparable to clinical laboratory analysers in measuring the majority of haematology, biochemistry and coagulation parameters in critically unwell patients, including those with infections. These devices may be deployed at the bedside to allow 'real-time' testing to improve patient care.
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The Lancet. Haematology · Jun 2015
Randomized Controlled TrialFiix-prothrombin time versus standard prothrombin time for monitoring of warfarin anticoagulation: a single centre, double-blind, randomised, non-inferiority trial.
Rapid fluctuations in factor VII during warfarin anticoagulation change the international normalised ratio (INR) but contribute little to the antithrombotic effect. We aimed to assess non-inferiority of anticoagulation stabilisation with a warfarin monitoring method affected only by factors II and X (Fiix-prothrombin time [Fiix-PT]) compared with standard PT-INR monitoring that includes factor VII measurement as well. ⋯ Innovation Center Iceland, University of Iceland Science Fund, Landspitali Science Fund and Actavis.
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Thrombosis research · Jun 2015
How the direct oral anticoagulant apixaban affects thrombin generation parameters.
Apixaban is a direct oral anticoagulant (DOAC) targeting factor Xa and thus quenching thrombin generation and clot formation. However, little information is available on the influence that apixaban may have on the parameters of thrombin generation. ⋯ These findings support the antithrombotic properties of apixaban and can help to understand the mechanism(s) of action of this drug. Thrombin generation could be used as a convenient laboratory tool to assess the anticoagulant activity of other drugs and to make between-DOAC comparison.
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Am. J. Clin. Pathol. · Feb 2015
Comparative StudyLaboratory measurements of the oral direct factor Xa inhibitor edoxaban: comparison of prothrombin time, activated partial thromboplastin time, and thrombin generation assay.
Edoxaban, an oral direct factor Xa inhibitor, does not require routine monitoring. However, assessment of the anticoagulant effects may be required in certain situations. ⋯ PT had disadvantages of a large variability among different PT reagents. aPTT could be used as a conventional and convenient test with a smaller variation among reagents. Thrombin generation was the most sensitive assay.
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Coagulation screens are performed routinely in every hospital with the notion that an abnormal result will pick up low levels of coagulation factors and thus aid in determining patients' bleeding risk. ⋯ Abnormal clotting screens may not always be associated with clinically significant decrease in coagulation factor.