Poct istat gen pnl
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Interdisciplinary clinical procedures with close interaction among medical professionals in these settings led to comparisons of ACT results generated by various instruments and revealed discordant ACT values, which prompted concern as well as a new proposal for implementation of the ACTPlus test system during vascular surgery procedures. Collectively, a combination of both i-STAT and HMSPlus methods are used in our operating rooms.
#Poct istat gen pnl Activator#
Perfusion uses the HMSPlus with kaolin activator in prewarm mode during cardiac surgery procedures. Anesthesiology uses the i-STAT with Celite clot activator in nonprewarm mode for monitoring patient hemostasis during cardiac catheterization procedures as well as the i-STAT with Celite activator in prewarm mode during interventional radiology and vascular surgery procedures.
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There is no “gold standard” reference measurement procedure for ACT, which hinders any efforts toward standardization of measured ACT values between test methods thus, comparative analyses of measured ACT values are particularly important.Īt our medical center, historical practices led to several different types of ACT analyzers, which varied by manufacturer of the instrument and methodology, being used in different clinical settings. Consideration of different POC test systems is emphasized in American College of Cardiology/American Heart Association Percutaneous Coronary Intervention guideline, which recommends use of different target ACT values on the basis of the device type ( 13). ACT measurements can vary depending on the type of POC test system used, including different manufacturers (or the same) the source of formula of the activator the amount of activator relative to sample volume or the method of clot detection ( 3, 5– 12). Variations in response to heparin therapy can be related to its pharmacology, the patient, methods for monitoring therapeutic effect, or some combination of the above factors ( 4). The target level of heparin anticoagulation can vary significantly depending on the clinical procedure, necessitating a wide ACT analytical measuring range ( 3). Similar to partial thromboplastin time, ACT results reflect the time of clot formation via the intrinsic coagulation pathway by the addition of factor XII activators (e.g., Celite, kaolin, glass beads, ellagic acid) and increase linearly in relation to the heparin concentration ( 2). Invasive or operative clinical procedures that use heparin therapy and ACT testing may include dialysis, cardiac catheterization and angiography, intraaortic balloon pumping, percutaneous coronary intervention, extracorporeal membrane oxygenation, vascular surgery, valve replacements, and others.
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Education of health-care professionals is needed regarding differences in measured ACT values if changing or interchanging ACT test systems.Īctivated clotting time (ACT) is a point-of-care (POC) coagulation test designed to monitor hemostasis in patients receiving heparin therapy in clinical situations in which intensive anticoagulation is required ( 1).
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The present study findings demonstrate differences in measured ACT values between 5 different POC ACT methods and the effect analytical variables have on ACT test performance. Measurement of ACT is particularly useful during interventional clinical procedures involving use of heparin therapy to facilitate rapid decision-making for management of patient hemostasis.