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Evaluation of a point-of-care coagulation analyzer on patients undergoing cardiopulmonary bypass surgery
Jack J Chavez1, Jeffrey S Weatherall, Stephen M Strevels
1Department of Anesthesiology, University of Tennessee Graduate School of Medicine, Knoxville, TN, USA. jchavez@mc.utmck.edu
Study Objective:
To evaluate a point-of-care (POC) coagulation monitoring analyzer (CoaguChek Pro DM) in patients undergoing cardiopulmonary bypass (CPB).
Design:
Prospective, blinded study.
Setting:
University hospital.
Participants:
32 patients scheduled for elective cardiac surgery with CPB.
Intervention:
Arterial blood samples were drawn four times: preoperatively, postinduction, and 10 minutes and 60 minutes after reversal of heparin with protamine.
Measurements And Main Results:
Activated partial thromboplastin time (aPTT) and prothrombin time (PT) were measured with a point-of-care system--CoaguChek Pro DM as well as with the Core Laboratory facility using a MD180 analyzer. A total of 128 consecutive paired analyses were conducted. There was very good agreement of the point-of-care-based monitoring of aPTT and PT with the Core Laboratory-based monitoring of aPTT and PT (positive correlations by linear regression analysis: r2 = 0.83 and 0.92, respectively). The turn-around time (time from blood sampling until availability of data for the anesthesiologists) was significantly shorter for the point-of-care system (averaging <10 min) than for the Core Laboratory system (averaging >30 min).
Conclusion:
CoaguChek Pro DM is a reliable and time-efficient point-of-care system for monitoring coagulation of patients undergoing CPB. The use of this system may improve patient care in this group through timely and accurate clinical decisions.
