[Near-patient testing devices to monitor vitamin K antagonists].
Monitoring of the anticoagulant effect with the International normalized ratio (INR) is essential for patients receiving vitamin K antagonists (VKAs). The majority of point of care (POC) devices for INR monitoring has shown a good precision and accuracy with results similar to those obtained in a laboratory. In many countries, INR POC devices are widely used at home by the patients for self-testing. Their use in the hospital by the clinical staff (doctor or nurses) for bedside measurement is also growing. The INR POC testing is performed using fully automated devices. Capillary blood samples are easy to obtain. In the emergency room, POC INR devices are commonly used. This improves the quality of care for patient with suspicion of VKAs overdosage. INR measurement using bedside monitors is also of great interest in care units for specific populations of patients like paediatrics or geriatrics. Moreover, bedside INR monitoring may be useful in anticoagulant clinics or when the care unit is far from a laboratory. Although the bedside INR monitors are easy to use, their implementation requires adequate training and intermittent re-evaluation of any person performing the tests to ensure reliability of results. Such equipment must comply with EN ISO 22870 standard for POC testing accreditation, under the supervision of a biologist. In order to achieve these targets, connect the instrument to the laboratory's data management system is essential.
Laboratoire d'hématologie, CHU Côte de Nacre, Caen.
Marie
M
Brionne-Francois
Agnès
A
Le Querrec
Dominique
D
Lasne
D015110:4-Hydroxycoumarins / Q000627:therapeutic use*; D000368:Aged; D000925:Anticoagulants / Q000627:therapeutic use*; D002648:Child; D004864:Equipment and Supplies / Q000592:standards; D006403:Hematologic Tests / Q000295:instrumentation / Q000379:methods; D006801:Humans; D007192:Indenes / Q000627:therapeutic use*; D008991:Monitoring, Physiologic / Q000295:instrumentation* / Q000379:methods / Q000592:standards; D019095:Point-of-Care Systems / Q000331:legislation & jurisprudence / Q000592:standards; D013923:Thromboembolism / Q000097:blood / Q000188:drug therapy*; D013927:Thrombosis / Q000097:blood / Q000188:drug therapy*; D014812:Vitamin K / Q000037:antagonists & inhibitors* / Q000627:therapeutic use
D015110:4-Hydroxycoumarins; D000925:Anticoagulants; D007192:Indenes; C011664:antivitamins K; D014812:Vitamin K
INR; point of care test; vitamin K antagonists