![]() ![]() Hemochron Junior Point of care test activated partial thromboplastin time heparin infusion intensive care patients.Ĭopyright © 2019 Royal College of Pathologists of Australasia. The POC APTT results were not sufficiently accurate for use in patients on heparin infusion compared to laboratory APTT assay. The agreement between clinical decisions regarding heparin dosage based on the two methods was poor for plain and citrated blood (kappa 0.35 and 0.11, respectively). When POC APTT results of less than 90 seconds using whole blood were compared to laboratory APTT results, the limits of the agreement became narrower (-23.243 to 28.419), and the mean percentage bias decreased to 5%. Creatinine- used in the diagnosis and treatment of renal diseases, in monitoring renal dialysis. Potassium- monitoring and aiding in the diagnosis of diseases and clinical conditions that manifest high and low potassium levels. Sodium- monitoring electrolyte imbalances. The 95% limits of agreement were widest (-27.266 to 64.791) and mean percentage bias was highest (24%) for the comparison between POC APTT using citrated blood and laboratory APTT. Performed at authorized locations by point of care operators. Despite the statistically significant correlation, the overall agreement tested by the Bland-Altman method was poor. The mean turnaround time for the point of care APTT result was significantly shorter than the central laboratory result (5.0☐.2 min vs 64.6☒.7 min, p<0.0001). A total of 176 paired samples from 44 patients (mean age 63 years, 64% males, mean APACHE 18) were analysed. ![]() We used the Bland-Altman method to test the statistical agreement between the two measurements and Cohen's kappa statistic to test the clinical agreement regarding heparin dosing decision. At 3 hours post-admission, the sensitivity increased to 95 versus 100, and specificity was 100 versus 94.3 when compared to lab HsTnT. We measured APTT by two methods: bedside POC test (Hemochron Junior Signature Plus) and central laboratory method (STA analyser). At 0 hour, the POC TnI assay had a lower sensitivity (72.5 versus 97.5) and had almost equal specificity (99.24 versus 93.2) when compared to lab HsTnT assay. We screened all patients admitted to the intensive care unit (ICU) at St George Hospital, Sydney, over a 7-month period and enrolled those who were receiving intravenous heparin infusion. The objective of this study was to assess the agreement between POC activated partial thromboplastin time (APTT) and laboratory APTT results in patients on heparin infusion and to determine its impact on the clinical decisions regarding heparin dosage. Data are limited on the performance of these devices in critically ill patients, especially those on heparin infusion. Point of care (POC) devices are increasingly being used in intensive care units to obtain faster results. ![]()
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