Point‐of‐care testing in haemostasis

@article{Perry2010PointofcareTI,
  title={Point‐of‐care testing in haemostasis},
  author={David J. Perry and David A Fitzmaurice and Steve Kitchen and Ian J. Mackie and Susan Mallett},
  journal={British Journal of Haematology},
  year={2010},
  volume={150}
}
Point‐of‐care testing (POCT) in haematology has seen a significant increase in both the spectrum of tests available and the number of tests performed annually. POCT is frequently undertaken with the belief that this will reduce the turnaround time for results and so improve patient care. The most obvious example of POCT in haemostasis is the out‐of‐hospital monitoring of the International Normalized Ratio in patients receiving a vitamin K antagonist, such as warfarin. Other areas include the… 
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References

SHOWING 1-10 OF 119 REFERENCES
Guidelines for point‐of‐care testing: haematology
This guideline provides a framework for the arrangement of point‐of‐care testing (POCT) services, previously known as near patient testing (patient self‐testing not covered). POCT is defined as any
The role of PFA‐100® testing in the investigation and management of haemostatic defects in children and adults
TLDR
The up to date, evidence‐based, advantages and disadvantages of the PFA‐100® test in the investigation and management of haemostatic disorders in both children and adults are highlighted.
Evaluation of a New Point-of-care Test that Measures PAF-mediated Acceleration of Coagulation in Cardiac Surgical Patients
TLDR
The HemoSTATUS assay may be useful in the identification of patients at risk for excessive blood loss and who could benefit from administration of DDAVP and/or platelet transfusion.
Near‐patient testing of haemostasis in the operating theatre: an approach to appropriate use of blood in surgery
TLDR
Bedside‐activated partial thromboplastin time and prothrombin time performed with the Coaguchek monitor seem to be reliable and have been used to build algorithms for transfusion decision making and to implement the use of TEG in the routine practice.
Point-of-care testing for prothrombin time, but not activated partial thromboplastin time, correlates with laboratory methods in patients receiving aprotinin or epsilon-aminocaproic acid while undergoing cardiac surgery.
TLDR
Coagulation parameters obtained from a whole blood POCT coagulation device with a typical laboratory instrument in cardiac surgery patients receiving aprotinin, epsilon-aminocaproic acid, or normal saline before undergoing cardiopulmonary bypass are compared.
A comparison of point-of-care instruments designed for monitoring oral anticoagulation with standard laboratory methods.
TLDR
Clinicians using point-of-care anticoagulation monitoring should be aware of differences between POC and parent laboratory values, as POC INR biases exist between laboratory methods and POC devices.
Point of care and central laboratory determinations of the aPTT are not interchangeable in surgical intensive care patients
TLDR
POC aPTT showed a poor agreement in SIC patients admitted after surgery, although in healthy volunteers or in control patients, this agreement was better and the best test to monitor heparin treatment in this setting was anti-factor Xa activity.
Central laboratory and point of care assessment of perioperative hemostasis
  • P. Sié, A. Steib
  • Medicine
    Canadian journal of anaesthesia = Journal canadien d'anesthesie
  • 2006
TLDR
The investigation of hemostasis at the central laboratory and POC testing have distinct objectives and the utility of the former for the diagnosis and the adjustment of therapeutics have been well demonstrated.
In vitro comparison of the effect of heparin, enoxaparin and fondaparinux on tests of coagulation.
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