![]() The Abbott iStat platform uses fresh blood mixed with diatomaceous earth, a particulate clotting activator, and a thrombin substrate. They also noted that the Hepcon platform requires a large specimen volume per test, has the largest upfront cost investment per instrument, and occupies the largest amount of space among the POC platforms. It provides an ACT measurement by an indirect, mechanical measurement of photooptic impedance of a plunger, which slows during clot formation.īy providing POC heparin concentration and ACT values, the Hepcon platform may represent an overall index of anticoagulation, but it requires an accurate estimation of blood volume, the researchers said. ![]() Medtronic's Hepcon Hemostasis Management System (HMS) Plus uses a microprocessor-based multichannel cartridge to quantitatively determine the heparin concentration of whole blood via the principle of heparin/protamine titration. The Hemochron Response platform detects clot formation by the disruption of a magnet at the base of the test tube when a clot is formed. The Signature Elite ACT+ platform measures clot formation by detecting the impedance of flow between two optical sensors. The researchers noted that the Accriva Hemochron Signature Elite ACT+ and Hemochron Response are widely available ACT monitoring systems. Benefits include shorter time between gathering specimens and receiving results, use of specimens with less volume, and a reduction in mishandling and mislabeling of specimens. Point-of-care activated clotting time measurements also provide advantages over laboratory-based tests for these applications, Singh said. An anti-Xa assay directly measures heparin level by detecting a color change using a chromogenic substrate that binds to free heparin.Īctivated clotting time, which can be measured by a variety of point-of-care platforms, has an advantage over the other two methods in that it enables use of whole blood without requiring that citrated plasma be drawn off after centrifugation, the investigators said. As fibrin strands form, the absorbance increases, and less light is perceived by the detector. ![]() Among them, the three most commonly used are assays for activated partial thomboplastin (aPTT) time, anti-Xa, and activated clotting time (ACT).Īn aPTT assay monitors clot formation by measuring the absorbance of light passed through a specimen. In all, the investigators analyzed the performance and cost of five tests available for the monitoring of heparin-induced anticoagulation. "Our investigation was triggered by external proficiency testing done by the College of American Pathologists, which revealed that results from the Hemochron instrument could be unreliable." "A number of instruments are available that you can use at the patient's bedside to monitor heparin treatment," Singh said. None of the instrument manufacturers responded to requests for comment on the study results. In parallel testing of instruments at Medical College of Georgia, the investigators compared the iStat with other instruments, including the Accriva Hemochron Signature Elite ACT+ and Hemochron Response analyzer produced by Instrumentation Laboratory, a Werfen company, and the Medtronic Hepcon Hemostasis Management System. Overall, the assessment was part of a quality management program in which the investigators evaluate analyzers on an ongoing basis to ascertain whether they meet patients’ needs, he said.ĭuring procedures such as open-heart surgery, cardiothoracic surgery, or inserting stents to improve blood flow in the heart, patients are given anticoagulants to prevent blood clots from forming, and the patients require bedside monitoring to make sure the drugs aren't causing problems such as excessive bleeding.įast-acting heparin is frequently administered as an anticoagulant, and clinicians usually use a measurement of activated clotting time to monitor the effectiveness of their treatments. "This was a comparison of the different instruments available, and we're indicating that one instrument is better than the others without having a vested interest in any of them," Gurmukh Singh, chief of clinical pathology at the Medical College of Georgia and the study's senior author, said in an interview. ![]() The investigators published the results of their study recently in the journal Lab Medicine. NEW YORK (360Dx) – Clinicians at Medical College of Georgia in Augusta have conducted a head-to-head comparison of instruments and tests used to monitor blood clotting during medical and surgical procedures, concluding that the Abbott iStat point-of-care analyzer performed the best. ![]()
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