Blood coagulation monitoring

Point-of-care coagulation monitoring normally works in the following way  

Other companies have in the past used alternative technologies, such as fluorescence. This is based on the fact that thrombin, which is formed during the clotting process, is a fluorescent molecule. 

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Point of care (POC) blood coagulation monitoring technologies... 

Blood coagulation tests are usually ordered before and during heparin tiierapy, and die dose of heparin is adjusted to die test results. Optimal results of therapy are obtained when the APTT is 1.5 to 2.5 times the control value The LMWHs do not require close monitoring of blood coagulation tests. 

If administration of this drug is necessary, the nurse monitors the patient s blood pressure and pulse rate every 15 to 30 minutes for 2 hours or more after administration of the heparin antagonist. The nurse immediately reports to the primary health care provider any sudden decrease in blood pressure or increase in the pulse rate The nurse observes the patient for new evidence of bleeding until blood coagulation tests are within normal limits. To replace blood loss, the primary health care provider may order blood transfusions or fresh frozen plasma... 

FAT EMULSIONS. When a fat emulsion is administered, the nurse must monitor the patient s ability to eliminate the infused fat from the circulation. The lipidemia must clear between daily infusions. The nurse monitors for lipidemia through assessing the result of the following laboratory exams hemogram, blood coagulation, liver function tests, plasma lipid profile, and platelet count. The nurse reports an increase in any of these laboratory examinations as abnormal. 

For pH sensors used in in-vivo applications, especially those in continuous pH monitor or implantable applications, hemocompatibility is a key area of importance [150], The interaction of plasma proteins with sensor surface will affect sensor functions. Thrombus formation on the device surface due to accelerated coagulation, promoted by protein adsorption, provided platelet adhesion and activation. In addition, variation in the blood flow rate due to vasoconstriction (constriction of a blood vessel) and sensor attachment to vessel walls, known as wall effect , can cause significant errors during blood pH monitoring [50, 126],... 

Hypersensitivity to heparin severe thrombocytopenia uncontrolled bleeding (except when it is due to DIG) any patient for whom suitable blood coagulation tests cannot be performed at the appropriate intervals (there is usually no need to monitor coagulation parameters in patients receiving low-dose heparin). 

In 13 men with advanced hormone-refractory prostate cancer the interaction between suramin and warfarin was studied because of potential worries that suramin may affect blood coagulation (38). After initial stabilization to an International Normalized Ratio (INR) of about 2.0 suramin plus hydrocortisone was started, after which warfarin requirements fell by 0.50-0.78 mg/day. The difference did not reach statistical significance. There were no bleeding problems. These results suggest that suramin and warfarin can be safely co-administered, provided that coagulation status is monitored. 

Gronewold, T.M.A., Glass, S., Quandt, E., Famulok, M. (2005). Monitoring complex formation in the blood coagulation cascade using aptamer-coated SAW sensors. Biosens. Bioelectron. 20, 2044-2052... 

Puckett L.G., Barrett G., Kouzoudis D., Grimes C., and Bachas L.G. 2003. Monitoring blood coagulation with magnetoelastic sensors. Biosensors and Bioelectronics 18 675-681. 

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