Evaluation of a point-of-care coagulation analyzer on patients undergoing cardiopulmonary bypass surgery

Study Objective: To evaluate a point-of-care (POC) coagulation monitoring analyzer (CoaguChek(TM) Pro DM) in patients undergoing cardiopulmonary bypass (CPB). Design: Prospective, blinded study. Setting: University hospital. Participants: 32 patients scheduled for elective cardiac surgery with CPB. Intervention: Arterial blood samples were drawn four times: preoperatively, postinduction, and 10 minutes and 60 minutes after reversal of heparin with prolamine. Measurements and Main Results: Activated partial thromboplastin time (aPTT) and prothrombin time (PT) were measured with a point-of-care system-CoaguChek(TM) Pro DM as well as with the Core Laboratory facility using a AM180 analyzer. A total of 128 consecutive paired analyses were conducted. There was very good agreement of the point-of-care-based monitoring of aPTT and PT with the Core Laboratory-based monitoring of aPTT and PT (positive correlations by linear regression analysis: r(2) = 0.83 and 0.92, respectively). The turn-around time (time from blood sampling until availability of data. for the anesthesiologists) was significantly shorter for the point-of-care system (averaging < 10 min) than for the Core Laboratory system (averaging > 30 min). Conclusion: Coagu Chek(TM) Pro DM is a reliable and time-efficient point-of-care system for monitoring coagulation of patients undergoing CPB. The use of this system may improve patient care in this group through timely and accurate clinical decisions. (C) 2004 by Elsevier Inc.