Joshi Ashish, Smith Diane, Arora Mohit, Poston Robert
Department of Information Systems, University of Maryland, Baltimore County, Baltimore, MD 21201, USA.
Interact Cardiovasc Thorac Surg. 2008 Dec;7(6):1035-8. doi: 10.1510/icvts.2008.186742. Epub 2008 Sep 4.
We conducted a feasibility study to monitor coagulation using a point-of-care device (proTime micro coagulation system) in ventricular assist device (VAD) patients. The aim of the study was to compare International Normalized Ratio (INR) readings using a standard laboratory method and proTime micro coagulation device in order to confirm a correlation between these two methods. The nurse's feedback about anticoagulation monitoring using portable anticoagulant monitoring devices in the hospital was also assessed. Four patients admitted in the cardiac surgery unit at University of Maryland, Baltimore were enrolled between 25 November 2006 and 20 December [corrected] 2006. These patients had given consent to undergo both venous and finger-stick blood samplings to monitor their anticoagulant levels. Six hospital nurses participated in the study. Forty-one INR readings were compared using both methods. Correlation coefficients determined association between INR readings using two methods. All the patients were males and were hypertensive. Significant positive association was seen in the INR readings using two methods (r=0.96; P<0.0001). Four of the six nurses believed patients would be significantly safer if INR is monitored by VAD patients in their homes. Further research needs to be done to determine the impact of home INR monitoring and long-term health in these patients.
我们开展了一项可行性研究,以使用床旁检测设备(proTime微型凝血系统)对心室辅助装置(VAD)患者的凝血情况进行监测。该研究的目的是比较采用标准实验室方法和proTime微型凝血装置测得的国际标准化比值(INR)读数,以确认这两种方法之间的相关性。我们还评估了护士对于在医院使用便携式抗凝监测设备进行抗凝监测的反馈。2006年11月25日至2006年12月20日[校正后]期间,招募了巴尔的摩马里兰大学心脏外科病房收治的4例患者。这些患者已同意接受静脉血和指尖血采样,以监测其抗凝水平。6名医院护士参与了该研究。使用两种方法对41个INR读数进行了比较。相关系数确定了两种方法测得的INR读数之间的关联。所有患者均为男性,且患有高血压。两种方法测得的INR读数之间存在显著正相关(r = 0.96;P < 0.0001)。6名护士中有4名认为,如果VAD患者在家中进行INR监测,患者会明显更安全。需要开展进一步研究,以确定家庭INR监测对这些患者的影响以及长期健康状况。