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Thromb Haemost 2009; 102(01): 159-165
DOI: 10.1160/TH09-01-0056
New Technologies, Diagnostic Tools and Drugs
Schattauer GmbH

Point-of-care monitoring of oral anticoagulation therapy in children

Comparison of the CoaguChek XS® system with venous INR and venous INR using an International Reference Thromboplastin preparation (rTF/95)
Anthea Greenway
1   Department of Haematology, The Royal Children’s Hospital, Parkville Australia
2   Haematology Research Group, The Murdoch Children’s Research Institute, Parkville, Australia
,
Vera Ignjatovic
2   Haematology Research Group, The Murdoch Children’s Research Institute, Parkville, Australia
,
Robyn Summerhayes
2   Haematology Research Group, The Murdoch Children’s Research Institute, Parkville, Australia
,
Fiona Newall
1   Department of Haematology, The Royal Children’s Hospital, Parkville Australia
2   Haematology Research Group, The Murdoch Children’s Research Institute, Parkville, Australia
,
Janet Burgess
3   Pathology Collection, Department of Laboratory Services, The Royal Children’s Hospital, Parkville, Australia
,
Lydia DeRosa
4   Core Laboratory, Department of Laboratory Services, The Royal Children’s Hospital, Parkville, Australia
,
Paul Monagle
1   Department of Haematology, The Royal Children’s Hospital, Parkville Australia
2   Haematology Research Group, The Murdoch Children’s Research Institute, Parkville, Australia
› Author AffiliationsFinancial support: Dr. Greenway is supported by The Royal Australasian College of Physicians Shield’s Research Entry Scholarship, The Murdoch Children’s Research Institute (Medical Scholar) and The Royal College of Pathologists of Australasia (Research Scholarship).
Further Information

Publication History

Received: 22 January 2009

Accepted after major revision: 19 April 2009

Publication Date:
24 November 2017 (online)

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Summary

Point-of-care (POC) monitoring of oral anticoagulation has been widely adopted in both paediatric and adult patients. A new POC system, the CoaguChek XS® has recently been developed to measure the international normalised ratio (INR) and may offer significant advantages. The CoaguChek XS® utilises a new method of electrochemical clot detection based on thrombin generation. This system has not been previously evaluated in children with reference to the laboratory gold standard, the prothrombin time using reference thromboplastin. It was the objective to compare values obtained by the CoaguChek XS® system with both the venous INR and the gold standard for anticoagulant monitoring, prothrombin time with reference thromboplastin (rTF/95).To evaluate the impact of testing using the Coagu-Chek XS® on clinical anticoagulant dosing decisions. Fifty paired venous INR and capillary CoaguChek XS® results were obtained from 31 children (aged up to 16 years).The laboratory gold standard, a manual prothrombin time with reference thromboplastin (rTF/95) was additionally performed on 26 samples. Correlation between the CoaguChek XS® result and the venous INR was r= 0.810. Agreement between the CoaguChek XS result and the reference INR was shown to be higher (r=0.95), in the subset analysed by this method. Correlation between the venous INR and reference INR was r=0.90. Despite changes to the methodology of testing with the CoaguChek XS® POC monitoring system, the accuracy of this method when compared with both the venous INR and gold standard reference INR was satisfactory. This resulted in infrequent changes to clinical decision making regarding anticoagulation

Keywords

Children - CoaguChek XS® - point of care - reference thromboplastin - venous INR - warfarin
 

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