Assessment of point‐of‐care measurement of international normalised ratio using the <scp>C</scp>oagu<scp>C</scp>hek <scp>XS P</scp>lus system in the setting of acute ischaemic stroke

Nusa, D.; Harvey, Isabel; Almansouri, Abdulrahman Y.; Wright, Susan; Neeman, Teresa; Ahmad, Omar; Hughes, Andrew; Lueck, Christian J.

doi:10.1111/imj.12255

Cited by 15 publications

(20 citation statements)

References 16 publications

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“…In other settings like war casualties the time gained using this assay was approximately 26 min compared to the laboratory [11]. In ischemic strokes, time to lysis and detection of oral anticoagulants was reduced [12], and in patients after cardiopulmonary bypass PT was determined much earlier than by the laboratory by using this type of POC device [13].…”

Section: Discussionmentioning

confidence: 99%

Point of Care and Factor Concentrate-Based Coagulation Algorithms

Theusinger

Stein

Levy

2015

Transfus Med Hemother

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In the last years it has become evident that the use of blood products should be reduced whenever possible. There is increasing evidence regarding serious adverse events, including higher mortality and morbidity, related to transfusions. The use of point of care (POC) devices integrated in algorithms is one of the important mechanisms to limit blood product exposure. Any type of algorithm, especially the POC-based ones, allows goal-directed transfusions of blood products and even better targeted factor concentrate substitutions. Different types of algorithms in different surgical settings (cardiac surgery, trauma, liver surgery etc.) have been established with growing interest in their use as they offer objective therapy for management and reduction of blood product use. The use of POC devices with evidence-based algorithms is important in the bleeding patient independent of its origin (traumatic vs. surgical). The use of factor concentrates compared to the classical blood products can be cost-saving, beneficial for the patient, and in agreement with the WHO-requested standard of care. The empiric and uncontrolled use of blood products such as fresh frozen plasma, red blood cells, and platelets without POC monitoring should no longer be followed with regard to actual evidence in literature. Furthermore, the use of factor concentrates may provide better outcomes and potential for cost saving.

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Section: Discussionmentioning

confidence: 99%

Point of Care and Factor Concentrate-Based Coagulation Algorithms

Theusinger

Stein

Levy

2015

Transfus Med Hemother

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“…The normal range of the Quick's value is 70 to 100%, but might depend on the reagents used in different devices. The reliability of these POC devices was investigated in several studies, demonstrating a high correlation of POC results compared with the results of conventional assessment of INR [45][46][47][48][49] and aPTT. 49 No technical difficulties in rapid assessment of INR were observed and all results were normally achieved within 2 minutes.…”

Section: Pt and Aptt: Coaguchekmentioning

confidence: 99%

“…46,48 Nusa and colleagues thus concluded that POC INR measurements should be used to shorten door-to-needle time in patients after an acute ischemic stroke. 45 To support on-site decision making, POC INR devices provide fast and reliable results for patients with suspected deficiencies of coagulation factors and are also feasible in prehospital emergency care. 47,49 Nonetheless, the CoaguChek is approved only to monitor the effect of vitamin K antagonists (e.g., phenprocoumon).…”

Section: Pt and Aptt: Coaguchekmentioning

confidence: 99%

Point-of-Care Coagulation Monitoring in Trauma Patients

Stein

Kaserer

Spahn

et al. 2017

Semin Thromb Hemost

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Trauma remains one of the major causes of death and disability all over the world. Uncontrolled blood loss and trauma-induced coagulopathy represent preventable causes of trauma-related morbidity and mortality. Treatment may consist of allogeneic blood product transfusion at a fixed ratio or in an individualized goal-directed way based on point-of-care (POC) and routine laboratory measurements. Viscoelastic POC measurement of the developing clot in whole blood and POC platelet function testing allow rapid and tailored coagulation and transfusion treatment based on goal-directed, factor concentrate-based algorithms. The first studies have been published showing that this concept reduces the need for allogeneic blood transfusion and improves outcome. This review highlights the concept of goal-directed POC coagulation management in trauma patients, introduces a selection of POC devices, and presents algorithms which allow a reduction in allogeneic blood product transfusion and an improvement of trauma patient outcome.

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“…The paper by Nusa et al . investigates the use of a blood clotting point of care device (CoaguChek XS System; Roche Diagnostics, Mannheim, Germany) to derive quickly international normalised ratio (INR) prior to commencing stroke thrombolysis.…”

mentioning

confidence: 99%

“…[8][9][10] These approaches are best implemented across healthcare services, and indeed, many Australian ambulance services have updated clinical protocols to enable a system-wide approach, with excellent results. 9,11 The paper by Nusa et al 12 investigates the use of a blood clotting point of care device (CoaguChek XS System; Roche Diagnostics, Mannheim, Germany) to derive quickly international normalised ratio (INR) prior to commencing stroke thrombolysis. Standard laboratory INR testing can take up to 30 min (or longer), which is unacceptable in the context of the time-critical treatment of acute ischaemic stroke.…”

mentioning

confidence: 99%