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Anticoagulant monitoring in ventricular assist device patients: a feasibility study

^a Department of Information Systems, University of Maryland, Baltimore County, 1000 Hilltop Circle, Baltimore, MD 21201, USA
^b Division of Cardiac Surgery, University of Maryland, School of Medicine, Baltimore, MD, USA

Corresponding author. Tel.: +1-410-455-8837; fax: +1-410-455-1217.

E-mail address: asjoshi{at}umbc.edu (A. Joshi).

We conducted a feasibility study to monitor coagulation using a point-of-care device (proTime micro coagulation system) in ventricular assist device (VAD) patients. The aim of the study was to compare International Normalized Ratio (INR) readings using a standard laboratory method and proTime micro coagulation device in order to confirm a correlation between these two methods. The nurse's feedback about anticoagulation monitoring using portable anticoagulant monitoring devices in the hospital was also assessed. Four patients admitted in the cardiac surgery unit at University of Maryland, Baltimore were enrolled between 25 November 2006 and 17 January 2006. These patients had given consent to undergo both venous and finger-stick blood samplings to monitor their anticoagulant levels. Six hospital nurses participated in the study. Forty-one INR readings were compared using both methods. Correlation coefficients determined association between INR readings using two methods. All the patients were males and were hypertensive. Significant positive association was seen in the INR readings using two methods (r=0.96; P<0.0001). Four of the six nurses believed patients would be significantly safer if INR is monitored by VAD patients in their homes. Further research needs to be done to determine the impact of home INR monitoring and long-term health in these patients.

Key Words: Anticoagulation; Ventricular assist device; Portable device; Point-of-care; Nurses