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Point-of-Care Testing in Hemostasis

Gardiner, C; Kitchen, D; Machin, S; Mackie, I; (2013) Point-of-Care Testing in Hemostasis. pp. 147-156. 10.1002/9781118543467.ch14.

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Abstract

Point-of-care testing (POCT) provides a rapid service that may be useful in life-threatening situations, to inform urgent therapeutic decisions, and manage long term conditions. The main haemostasis applications are: Vitamin K antagonist therapy (VKA) (INR), high dose heparin management (ACT), assessing blood product requirements during major surgery (thrombelastography, thromboelastometry), platelet function testing, and D-dimer testing for venous thrombosis exclusion. All POCT devices have automatic verification procedures, but some INR and ACT devices also have an electronic quality control (QC) cartridge that simulates a test. Internal QC systems are sometimes incorporated in the test strip, helping to ensure validity. However QC systems independent of the manufacturer are preferred (e.g., using lyophilized plasma) and external quality assessment (EQA) is essential. For ACT and thrombelastography, QC samples should be tested every working day; EQA schemes have recently been introduced in the UK for some devices. However, lyophilized QC plasmas are not ideal due to the lack of red blood cells and platelets, which have impact on the results. Commercial QC materials are available for D-dimer testing and EQA services are under development. This edition first published 2013 © 2009 © Blackwell Publishing Ltd; 2013 John Wiley & Sons, Ltd.

Type: Article
Title: Point-of-Care Testing in Hemostasis
DOI: 10.1002/9781118543467.ch14
UCL classification: UCL > Provost and Vice Provost Offices
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Medical Sciences
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Medical Sciences > Cancer Institute
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Medical Sciences > Cancer Institute > Research Department of Haematology
URI: http://discovery.ucl.ac.uk/id/eprint/1422623
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