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Point-of-care testing of activated clotting time in the ICU: Is it relevant?
Brown, Ellenora Clarke, Jody Edward, Karen-Leigh Giandinoto, Jo-Ann Michelle
Brown, Ellenora
Clarke, Jody
Edward, Karen-Leigh
Giandinoto, Jo-Ann Michelle
Abstract
Background: Over the past 50 years there have been significant advances in both the clinical techniques and equipment used in the intensive care environment. One traditionally used point-of-care test is activated clotting time (ACT), a coagulation test primarily used during cardiopulmonary bypass surgery to monitor the anticoagulation effects of heparin. The ACT test has since emerged into the intensive care environment to guide clinical assessment and management of haemostasis in postoperative cardiac patients. Objectives: The aim of this integrative systematic review was to critique the available research evaluating the effectiveness of ACT point-of-care testing in the intensive care unit for adult patients following cardiopulmonary bypass and cardiac surgery and any impacts this may have on nursing care. Methods: A systematic search of Medline, CINAHL and PubMed was undertaken. Results: The search identified five research papers reporting on the use of ACT point-of-care testing in the intensive care unit for adult cardiac surgical patients. Meta-analysis was not performed due to the lack of homogeneity between the papers included. Conclusions: There was a lack of clear evidence for the use of the ACT point-ofcare test after cardiac surgery in the intensive care environment. This review has highlighted that conventional laboratory tests are generally more accurate and reliable than this point-of-care test in guiding nursing care management.
Keywords
activated clotting time, point-of-care testing, intensive care unit, nursing assessment, systematic review
Date
2016
Type
Journal article
Journal
British Journal of Nursing
Book
Volume
25
Issue
11
Page Range
608-612
Article Number
ACU Department
School of Nursing, Midwifery and Paramedicine
Faculty of Health Sciences
Faculty of Health Sciences
Relation URI
Source URL
Event URL
Open Access Status
License
File Access
Controlled