Whole Blood International Normalization Ratio Measurements in Children Using Near-Patient Monitors

Nowatzke, William; Landt, Michael; Smith, Carl C.; Wilhite, Timothy R.; Canter, Charles E.; Luchtman‐Jones, Lori

doi:10.1097/00043426-200301000-00008

Cited by 31 publications

(33 citation statements)

References 10 publications

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“…17 For PT or international normalized ratio measurements in the pediatric population, and for international normalized ratio values ranging from 1.05 to 5.25, the near patient instrument with the least bias relative to the classical laboratory test (CA-1000) is the RapidpointCoag® (r 2 = 0.923), the correlations (r 2 ) of the CoaguCheck®, Hemochron Jr®., and ProTime® being 0.877, 0.834, and 0.885, respectively. 18 Bilirubin levels up to 20 mg·dL -1 (342 µmol·L -1 ) do not interfere with any of these methods. For other types of surgery, preoperative coagulation tests have been reported to be useful in predicting the magnitude of blood losses in open heart, liver transplant and scoliosis surgery.…”

Section: Preoperative Laboratory Investigationmentioning

confidence: 93%

Réduire les pertes sanguines et les besoins transfusionnels en chirurgie pédiatrique

Guay

Moerloose

Lasne

2006

Can J Anesth/J Can Anesth

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Purpose: To summarize the physiology and pathophysiology relevant to perioperative blood loss in children. Strategies to reduce blood losses are reviewed. Methods:The literature was reviewed using the electronic library PUBMED and the Cochrane Database of Systematic Reviews. Relevant studies published in English or French with an English abstract are included. The following keywords were used: children, blood transfusion, surgical blood loss, erythropoietin, autologous blood, red blood cell saver, normovolemic hemodilution, desmopressin, aminocaproic acid, tranexamic acid, aprotinin, cardiac surgery, liver transplantation and scoliosis surgery. Main findings:For patients with idiopathic scoliosis, predonation with or without the addition of erythropoietin is a safe and effective way to avoid the use of allogenic blood products. For open heart procedures: whole blood of less than 48 hr is helpful for children of less than two years of age undergoing complex procedures; tranexamic acid may be helpful for cyanotic heart disease and, to a lesser degree, for reoperations; while antikallikrein blood levels of aprotinin may both reduce the need for allogenic blood transfusions and improve postoperative oxygenation in infants. Conclusion:Reducing perioperative allogenic blood transfusions is possible in pediatric patients provided that prophylactic measures are adapted to age, disease and type of surgery. I N normal children perioperative blood loss leading to administration of allogenic transfusion may be encountered if: the surgical site does not allow easy access to surgical hemostasis, the surgery is performed on highly vascularized tissues that are not easily sutured or cauterized (for example bone elements such as in spinal fusion or correction of craniosynostosis) or the surgery itself induces various disturbances of hemostasis (dilution of factors and induction of fibrinolysis as in cardiac surgery with the use of extracorporeal bypass). The pathology justifying the surgical procedure may also induce various coagulation and/or hemostatic abnormalities. Children suffering from congenital cardiac or liver dis- ease may have thrombocytopenia, abnormal platelet function (congenital heart disease) and/or inadequate amounts of various coagulation factors. Objectif1 Perioperative management of children with congenital coagulation and hemostatic diseases will not be discussed in this review. Developmental aspects of hemostasisAn excellent summary of the developmental physiology of coagulation, based mainly on the extensive work of Maureen Andrew, may be found in a recent review by Kuhle et al. and is summarized in Table I.2 Since maternal coagulation factors do not cross the placental barrier, blood levels measured at birth are the result of fetal synthesis that starts around the fifth week of gestation. Fetal blood becomes clottable around 11 weeks of gestation. Except fetal fibrinogen which has an increased content of sialic acid, all coagulation and inhibitor factors are qualitatively normal at birth, and differ from...

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Section: Preoperative Laboratory Investigationmentioning

confidence: 93%

Réduire les pertes sanguines et les besoins transfusionnels en chirurgie pédiatrique

Guay

Moerloose

Lasne

2006

Can J Anesth/J Can Anesth

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“…142,143 Although not assessed in a formalized way, the major advantages identifi ed by families included reduced trauma of venipunctures, minimal interruption of school and work, ease of operation, and portability. [143][144][145][146][147][148][149] Recommendation 1.2. We suggest, for neonates and children receiving either once-or twice-daily therapeutic LMWH, that the drug be monitored to a target anti-Xa activity range of 0.5 to 1.0 units/mL in a sample taken 4 to 6 h after subcutaneous injection or 0.5 to 0.8 units/mL in a sample taken 2 to 6 h after subcutaneous injection (Grade 2C) .…”

Section: Monitoringmentioning

confidence: 99%

Antithrombotic Therapy in Neonates and Children

Monagle

Chan

Goldenberg

et al. 2012

Chest

1,269

559

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“…Unfortunately, only few studies evaluating capillary INR monitoring in children have been conducted so far [10,11,12,13,14,15,16]. In particular, very few pediatric data are available on the newer PT monitor, CoaguChek XS.…”

Section: Introductionmentioning

confidence: 99%

Self-Monitoring of Oral Anticoagulation Therapy in Children

Paioni¹,

Kroiss

Kägi³

et al. 2009

Acta Haematol

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This study aimed to investigate the accuracy of home International Normalized Ratio (INR) self-monitoring in pediatric patients on long-term oral anticoagulation therapy. Statistical and clinical agreement of INR values from capillary whole blood samples measured by 2 different portable prothrombin time monitors (CoaguChek S and XS) and venous blood samples measured by a laboratory coagulation analyzer were evaluated using the Bland-Altman analysis. Eighty-three INR comparisons (56 using the CoaguChek S and 27 using the CoaguChek XS) were obtained from 35 children aged 4 months to 18 years. Mean differences between venous and capillary INR values and their limits of agreement were –0.04 (–0.63 to 0.55) overall, 0.006 (–0.63 to 0.65) for the CoaguChek S and –0.13 (–0.57 to 0.31) for the CoaguChek XS. The Pearson correlation coefficients were 0.88 overall, 0.84 for the CoaguChek S and 0.95 for the CoaguChek XS. Expanded and narrow agreements for all patients were 97.6 and 94%, respectively. In conclusion, home INR self-monitoring is accurate for children requiring long-term oral anticoagulation therapy. Our data suggest that INR self-monitoring with the newer CoaguChek XS is more accurate than with the older CoaguChek S monitor.

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Whole Blood International Normalization Ratio Measurements in Children Using Near-Patient Monitors

Cited by 31 publications

References 10 publications

Réduire les pertes sanguines et les besoins transfusionnels en chirurgie pédiatrique

Réduire les pertes sanguines et les besoins transfusionnels en chirurgie pédiatrique

Antithrombotic Therapy in Neonates and Children

Self-Monitoring of Oral Anticoagulation Therapy in Children

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