PERIOPERATIVE RELIABILITY OF AN ON-SITE PROTHROMBIN TIME ASSAY UNDER DIFFERENT HEMOSTATIC CONDITIONS

Perioperative use of laboratory coagulation assays is limited by the d elay in obtaining results. The management of haemostasis during major surgical procedures requires rapid and accurate measurement of the pre vailing coagulation status. In this prospective study, we have evaluat ed the reliability of on-site prothrombin time assessed by the portabl e coagulation monitor CoaguChek-Plus compared with standard laboratory assays during elective non-cardiac surgery. Sixty-two patients were a ssigned to one of three groups: group A=normal preoperative coagulatio n where minor intraoperative blood loss is expected; group B=normal pr eoperative coagulation where major intraoperative blood loss is expect ed; and group C=preoperative anticoagulation and minor intraoperative blood loss expected. On-site prothrombin time and laboratory prothromb in time showed poor correlation in group A (r(2)=0.24; bias (2 SD) 1.8 0 (3.34) s) and group B (r(2)=0.30; 1.43 (3.12) s). The correlation in group C was better (r(2)=0.71; 1.41 (1.92) s). We conclude that proth rombin time measured with the CoaguChek-Plus monitor did not appear to be suitable for the management of haemostasis.