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Measurement of the international normalized ratio (INR) in hemodialysis patients with heparin-locked central venous catheters: evaluation of a novel blood sampling method
- Source :
- The journal of vascular access. 10(3)
- Publication Year :
- 2009
-
Abstract
- Background Accurate measurement of the international normalized ratio (INR) may be difficult in hemodialysis (HD) patients with heparin-locked central catheters. Blood contamination with locking solutions may interfere with INR measurement when samples are collected directly from the catheter. Methods The aim of our study was to evaluate a novel sampling method for the measurement of INR in HD patients with heparin-locked central catheters. This novel method consists of measuring the INR directly from the dialysis circuit (arterial bloodline sample port) after 1 hr of treatment regardless of heparin administration during dialysis. We compared this method to the gold standard (peripheral venipuncture prior to dialysis) using the paired t-test. We included 30 patients (23 with warfarin therapy and 7 without). Results INRs obtained using the novel sampling method were only minimally overestimated compared to venipuncture values (mean INR overestimation: 0.2 +/- 0.2). This overestimation was not clinically significant and did not lead to changes in warfarin prescription for any of the patients. Correlation tests confirmed the influence of heparin administration on INR overestimation (R=0.4; p=0.05). This influence was present mostly among patients receiving more than 100 Units/kg of heparin during their treatment. Conclusion This novel sampling technique provides a convenient and simple method of monitoring INR among HD patients.
- Subjects :
- Male
Catheterization, Central Venous
medicine.medical_treatment
030232 urology & nephrology
030204 cardiovascular system & hematology
03 medical and health sciences
0302 clinical medicine
Catheters, Indwelling
Phlebotomy
Predictive Value of Tests
Renal Dialysis
Medicine
Humans
International Normalized Ratio
Blood Coagulation
Dialysis
Aged
Aged, 80 and over
Blood Specimen Collection
Venipuncture
business.industry
Heparin
Warfarin
Anticoagulants
Equipment Design
Middle Aged
Catheter
Nephrology
Anesthesia
Kidney Failure, Chronic
Surgery
Female
Hemodialysis
business
Blood sampling
medicine.drug
Subjects
Details
- ISSN :
- 11297298
- Volume :
- 10
- Issue :
- 3
- Database :
- OpenAIRE
- Journal :
- The journal of vascular access
- Accession number :
- edsair.doi.dedup.....8e8f73ac761fa041a3cc8cf68f6081a0