A message from Sue Allen at Baptist Hospital: George, a while back you posted a question to the masses about the correlation between the Abbott i-STAT ACT versus the ITC Hemochron 401 and the Hemochron Jr. and I was wondering if you ever received any responses and have any further information on the subject. We are currently doing the same conversion and needless to say, the methods do not directly correlate. They do quite well at the lower ranges but at the 300–350 sec levels they seem to differ by as much as 100 seconds.Thank you in advance for any light you can shed on the subject.
From Kim Kinney at Indiana University Medical Center (IU Health): Hi George. We are being asked to make the thromboelastograph (TEG) available in our special coag lab for clinical use. I am curious to poll others regarding the use of TEG, who is running the test, who is interpreting the results, etc. We have had the TEG available for several research studies here at IU Health but the testing was performed by a research lab. Thanks for the help, Kim
Hi, Kim, it is great to hear from you again, and I hope we get some feedback! I rarely see TEGs in clinical labs, they seem to live mostly in operating suites where they are used to monitor heparin or thrombolytic therapy. Geo.
Back to our April 24 anticoagulation clinic manager’s question about when to validate a prolonged point of care (POC) prothrombin time with international normalized ratio (PT/INR). George spoke with representatives of Roche Diagnostics, distributor of Coag-U-Chek instruments, while attending the May 3–5 Thrombosis and Hemostasis Summit of North America meeting in Chicago. While Roche contends this is a local decision and makes no firm recommendation, their managers assert that most clinic operators choose 4.0 as the INR above which they send the patient for a follow-up venous PT/INR.
From Bob Gosselin: Hey GF, re point of care (POC) international normalized ratios (INRs), assuming that you are collecting a citrated sample for testing, a high hematocrit (HCT) should not matter for a system that employs fingerstick whole blood, since there is no citrate:plasma ratio issue at hand with using whole blood. Viscosity may be an issue with high HCTs and POC testing.
Robert Gosselin, CLS
Coagulation Specialist, University of California, Davis Health System
Department of Pathology and Laboratory Medicine, Specialty Testing Center