Point-of-care antithrombotic monitoring in children

Area of Science:

• Pediatric Pharmacology
• Clinical Pathology
• Biomedical Engineering

Background:

• Oral anticoagulant therapy use is rising in children, posing management challenges like difficult venous access.
• Point-of-care (POC) monitoring presents a promising solution for managing anticoagulant therapy in pediatric patients.
• This review synthesizes current literature on POC monitoring for oral anticoagulant therapy in children.

Purpose of the Study:

• To review existing literature on the use and efficacy of point-of-care (POC) monitoring for oral anticoagulant therapy in pediatric patients.
• To assess the accuracy, reliability, and patient preference for POC monitoring devices in children.
• To identify gaps in current research regarding POC monitoring in pediatric anticoagulant therapy.

Main Methods:

• A comprehensive Medline search was performed to identify relevant publications.
• Key papers were systematically reviewed, focusing on study objectives, patient populations, and POC devices utilized.
• Limitations of the included studies were critically evaluated.

Main Results:

• Five publications and one abstract were identified, detailing the use of five distinct POC monitors.
• Three studies emphasized clinical management, assessing target therapeutic range achievement and adverse event frequency.
• POC and laboratory results demonstrated strong correlation (0.83–0.96), with a preference for home monitoring and self-management via POC devices.

Conclusions:

• POC monitoring of oral anticoagulant therapy in children offers significant advantages, appearing accurate and reliable based on current literature.
• The impact of quality control issues, such as thromboplastin ISI calibration in POC devices, remains unexplored in pediatric settings.
• Further studies are essential to confirm the safety, reliability, and efficacy of POC monitoring, including home and self-management programs, in children.