Validation of a Point-of-Care Analyzer for Determining Anticoagulation Status During Air Transport

Area of Science:

• Critical care medicine
• Point-of-care testing
• Medical diagnostics

Background:

• Point-of-care testing (POCT) is crucial in critical care settings.
• Air transport of critically ill patients presents unique challenges for diagnostic testing.
• Prothrombin time (PT)/international normalized ratio (INR) monitoring is vital for managing anticoagulation and coagulopathy.

Purpose of the Study:

• To evaluate the feasibility, accuracy, and clinical value of a cartridge-based PT/INR analyzer during critical care air transport.
• To assess the impact of transport conditions on analyzer performance.

Main Methods:

• Prospective study involving blood sample analysis from adult patients during air transport.
• Feasibility assessed in 10 patients; accuracy determined by comparing results from 20 patients with laboratory standards.
• Clinical value evaluated through chart review of 110 patients receiving PT/INR testing.

Main Results:

• The analyzer demonstrated feasibility, with vibration not affecting performance.
• Average bias between the cartridge and laboratory methods was 0.0 INR units.
• Accuracy: 73% within 0.2 INR, 83% within 0.4 INR, and 93% within 0.6 INR of laboratory values.

Conclusions:

• The PT/INR cartridge analyzer is robust and reliable under the conditions of rotor-wing air transport.
• The device provides accurate and clinically valuable results, supporting timely patient management decisions in critical care transport.