P. Viars

Intraoperative measurement of activated partial thromboplastin time and prothrombin time with a new compact monitor

A prospective study was conducted to evaluate a new compact portable coagulation monitor (Ciba–Corning Biotrack 512 Monitor), which enables the clinician to perform instantaneous activated partial thromboplastin time (APTT) and prothrombin time (PT). 126 patients scheduled for heparinized and nonheparinized vascular surgery, and gynaecological surgery, were included. A drop of capillary or venous whole blood was applied in disposable cartridges to successively perform APTT and PT, and the results of the tests were compared with conventional laboratory methods, performed in two different laboratories (Lab. A and B). Comparisons between Lab. A. and Lab. B. enables determination of the bias, precision, and percent of outliers (patients whose values differed more than 20%) in conventional methods. The reference value was defined as the mean of Lab. A. and Lab. B. values. For PT, there were no statistical differences between the capillary and venous samples performed with the portable monitor, and the reference value, for the bias, the precision and the proportion of outliers. For APTT, there were no statistical differences between the capillary and venous samples performed with the portable monitor, and the reference value, for the bias and the precision. The percent of outliers, however, was significantly greater with the venous sample of the compact monitor than with the reference (48 versus 22%), and even if it did not reach the statistical significance (P = 0.07) it was also higher with the capillary sample performed with the Ciba Monitor than with the reference (33%). In conclusion the assessment of blood coagulation using this new compact monitor could be of major interest during the intraoperative period when immediate results are mandatory, even if PT is more accurate than APTT with this new method.