Point-of-care testing for coagulation function: CoaguChek (R) XS System versus standard laboratory testing in pediatric patients with normal and abnormal coagulation function

Hiromi Kako; Vidya T. Raman; Dmitry Tumin; Julie Rice; Joseph D. Tobias

doi:10.1007/s00540-017-2317-3

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Point-of-care testing for coagulation function: CoaguChek (R) XS System versus standard laboratory testing in pediatric patients with normal and abnormal coagulation function

Journal article

Peer reviewed

Point-of-care testing for coagulation function: CoaguChek (R) XS System versus standard laboratory testing in pediatric patients with normal and abnormal coagulation function

Hiromi Kako, Vidya T. Raman, Dmitry Tumin, Julie Rice and Joseph D. Tobias

Journal of anesthesia, Vol.31(3), pp.345-350

06/01/2017

DOI: 10.1007/s00540-017-2317-3

PMID: 28213667

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Abstract

Purpose Intraoperative abnormalities of coagulation function may occur for various reasons. In most scenarios, treatment is directed by laboratory parameters. Unfortunately, standard laboratory testing may take 1-2 h. The purpose of the current study was to evaluate a point-of-care testing device (CoaguChek (R) XS System) in pediatric patients. Methods Patients ranging in age from 2 to 18 years, undergoing posterior spinal fusion (PSF) or cardiac surgery using cardiopulmonary bypass (CPB) were eligible for inclusion. After CPB and/or the surgical procedure, 2.8 ml of blood was obtained and simultaneously tested on both the standard laboratory apparatus and the CoaguChek (R) XS System. Results The study cohort consisted of 100 patients (50 PSF and 50 cardiac cases) with 13 cases excluded, leaving 87 patients (49 PSF and 38 cardiac cases) for analysis. In PSF cases, reference laboratory international normalized ratio (INR) ranged from 0.98 to 1.77 while CoaguChek (R) XS INR ranged from 1.0 to 1.3. The correlation coefficient was 0.69. The results of the Bland-Altman analysis showed a bias of 0.09, precision of 0.1, and 95% limits of agreement ranging from -0.11 to 0.28. In cardiac cases, reference INR ranged from 1.68 to 14.19, while CoaguChek (R) XS INR ranged from 1.4 to 7.9. The correlation coefficient was 0.35. The results of the Bland-Altman analysis showed a bias of -1.8, precision of 2.1, and 95% limits of agreement ranging from -6.0 to 2.4. Conclusions INR values obtained from CoaguChek (R) XS showed a moderate correlation with reference laboratory values within the normal range. However, in the presence of coagulopathy, the discrepancy was significantly greater, thereby making the CoaguChek (R) XS clinically unreliable.

Anesthesiology

Life Sciences & Biomedicine

Science & Technology

Details

Title: Subtitle: Point-of-care testing for coagulation function: CoaguChek (R) XS System versus standard laboratory testing in pediatric patients with normal and abnormal coagulation function
Creators: Hiromi Kako - Nationwide Children's Hospital
Vidya T. Raman - Nationwide Children's Hospital
Dmitry Tumin - Nationwide Children's Hospital
Julie Rice - Nationwide Children's Hospital
Joseph D. Tobias - Nationwide Children's Hospital
Resource Type: Journal article
Publication Details: Journal of anesthesia, Vol.31(3), pp.345-350
DOI: 10.1007/s00540-017-2317-3
PMID: 28213667
ISSN: 0913-8668
eISSN: 1438-8359
Publisher: Springer Nature
Number of pages: 6
Grant note: Nationwide Children's Hospital; Ohio State University UL1TR001070 / CTSA; United States Department of Health & Human Services; National Institutes of Health (NIH) - USA; NIH National Center for Advancing Translational Sciences (NCATS) OSU CCTS
Language: English
Date published: 06/01/2017
Academic Unit: Anesthesia
Record Identifier: 9985178668602771

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