As an educational resource, the Clinical Affairs division of International Technidyne Corporation suggests the following references to enhance the understanding of the clinical science related to coagulation, blood gases, electrolytes, other chemistries, and point-of-care testing methodologies.  The references below have been either published or presented in a public forum and may be subjected to copyright restrictions.  Copies of these materials should be obtained either through the publication source or communication with the author.

Publications, Abstracts, Posters

-   Whole Blood Coagulation Systems for Monitoring Oral Anticoagulation Therapy

• Moore GW, Henley A, Cotton S, Tugnait S, Rangarajan S.  Clinically Significant Differences Between Point-Of –Care Analysers And Standard Analyzer For Monitoring the International Normalization Ratio in Oral Anticoagulant Therapy: A Multi-Instrument Evaluation In A Hospital Outpatient Setting. Blood Coagula and Fibrinolysis 2007; 18: 287-92.

• Völler H, Taborski U, Dovifat C, Hartwig I, Kadar JG, Wegscheider K, Zucker ML,LaDuca FM, Ansell J.  ProTime self-management yielding improvement of fluency and quality of life.  Thromb Haemost 2007; 98: 889-95.

• El Rouby S, Gonzales A, Zucker ML, Pan C, Cohen M.  The Influence of Prior Oral Anticoagulation Therapy on the Activated Clotting Time. Clin Chem 2006; 52: A186, E-71.

• Matchar DB, Jacobson AK, Edson RG, Lavori PW, Ansell JE, Ezekowitz MD, Rickles F, Fiore L, Boardman K, Phibbs C, Fihn SD, Vertrees JE, Dolor R. The impact of patient self-testing of prothrombin time for managing anticoagulation: rationale and design of VA Cooperative Study #481--the Home INR Study (THINRS).  J Thromb Thrombolysis 2005; 3:163-72.

• El Rouby S, Zucker1 ML, Ruybalid L, Gunneman T, LaDuca FM, Jacobson A.  Effective Anticoagulation Self-Management in a Diverse Population of Oral Anticoagulation Patients Using the ProTime System. J Thrombosis and Haemost  2005; Volume 3, Supplement 1:P1145.

• Perry S, Samsa GP, Ortel TL. Point-of-Care Testing of the International Normalized Ratio in Patients with Antiphospholipid Antibodies. Thromb Haemost 2005; 94: 1196-202.

• Sunderji R, Gin K, Shalansky K, Carter C, Chambers K, Davies C, Schwartz L, Fung A. Clinical impact of point-of-care vs. laboratory measurement of anticoagulation. Am J Clin Pathol 2005;123:184-8.

• Ansell J, Hirsh J, Pollen L, Bussey H, Jacobson A, Hylek E. The pharmacology and management of the vitamin K antagonists. The Seventh ACCP Conference on Antithrombotic and Thrombolytic Therapy. Chest 2004;126:204S-233S.

• El Rouby S, Mestres CA, LaDuca FM, Zucker ML, Racial and Ethnic Differences in Warfarin Response.   J Heart Valve Dis 2004; 1: 15-21.

• El Rouby S, Gunneman T, Ruybalid R L, Jacobson A, Snell B, Zucker ML, LaDuca FM,   Maintenance of the Safe and Effective Target Therapeutic Range for Oral Anticoagulation Therapy Using Patient Self-Testing.  Clin Chem 2002; 48, A-188.

• El Rouby S., Gunneman T, Ruybalid RL, Jacobson A, Snell B, Zucker ML., Frank M. L.  Frequent Prothrombin Time Patient Self-Testing Reduces Excessive Warfarin Dose Adjustments.  Proceeding of the international Society on Thrombosis and Haemostasis, XVIIIth congress, July 2001; P831.

-   Whole Blood Coagulation Systems for Monitoring Heparin Therapy

• Berruyer M, El Rouby S, Yasar Z Durbin S, Ffrench P, Galland P, Leitienne P.Monitoring of Low Molecular weight Heparin Nadroparin During Hemodialysis.  J. Thrombo Haemost 2007; Vol. 5, P 3155.

• El Rouby S, Thompson J, Williams J, Jobes D.  Evaluation of The Point of Care Micro-Coagulation tests in Pediatrics.  J. Thrombo Haemost 2007; Vol. 5, P 3148.

• El Rouby S, Cohen M,  Gonzales A, Hoppensteadt D, Lee T, Zucker ML, Khalid K,  LaDuca FM, Fareed J.  The use of a Hemochron® JR. Hemonox™ Point of Care Test in Monitoring the Anticoagulant Effects of Enoxaparin during Interventional Coronary Procedures.  J Thromb Thrombolysis 2006; 21:137-45.

• Tremey B, Szekely B, Schlumberger S, Francois D, Liu N, Sievert K , Fischler M.  Anticoagulation Monitoring During Vascular Surgery: Accuracy of the Hemochron low Range Activated Clotting Time (ACT-LR). Br. J. Anaesth 2006; 94: 453-9.

• Diez J, El Rouby S, Hoppensteadt D, Bowers S, Zucker ML, Fareed J, LaDuca FM.   Evaluation of the Anticoagulant Effect of Enoxaparin Using Clot Based Point of Care Tests.  J Thrombo Haemost 2005 Vol. 3, Supplement 1, P1023.

• El Rouby S, Seelmann R, Carter F, Cunningham R, Zucker LM, Walker T, Nye D.  Evaluation of Coagulation Profile in Obese Patients Receiving Subcutaneous Prophylactic Enoxaparin for Gastric Bypass. Point-of-Care Testing. Clin Chem 2006; 52: A186-E70.

• El Rouby S, Cohen M, Gonzalez A, Hoppensteadt D, Zucker ML, Lee T, Khalid K,  Fareed J, LaDuca FM.  Point of Care Monitoring of Enoxaparin in the Presence of GpIIb/IIIa Combined Therapy during Percutaneous Coronary Interventions (PCI).  POC 2005; 4: 30-35.

• Jaryno S, Zucker ML, LaDuca FM. The Hemochron Response RxDx Heparin and Protamine Dosing System. J Extra Corpor Technol 2004; 36:258-62.

• Cavusoglu E, El Rouby S,   Kunamneni PB,  Lau A, Lee T,  Hoppensteadt D,  Colella G, Zucker ML, LaDuca FM, Fareed J, Marmur JD.  Monitoring Low Molecular Weight Heparin (LMWH) During Interventional Coronary Procedures using a Sensitive Point-of-Care Assay.  Blood 2003; 102: A326.

• El Rouby S, Rinehart K, Zucker ML ,LaDuca FM.  Hand-Held Personal Digital Assistant Program for the HEMOCHRON RxDx Heparin and Protamine dosing system. J Extra Corpor Technol 2003 Sep; 35:212-7.

• Jaryno SA, Zucker ML, El Rouby S, Franks BL, Nichols J, Anestis K, et al. Validation of the Hemochron Jr. Signature+ Microcoagulation System and the Hemochron Configuration Manager. POC  2003; 2:129-34.

• Lee T, El Rouby S, Zucker ML, Cohen M, Colella G, LaDuca FM   A Novel Recombinant Tissue Factor Assay for Measuring the Anti-Xa effect of Low Molecular Weight Heparin: Implications for Cardiac Interventions.  XIX Congress of the International Society on Thrombosis and Haemostasis.  J Thrombo Haemos 2003 Vol. 1, Supplement 1, P1895 

• El Rouby S, Burnhiemer B,  Mahmood A, Zucker ML, LaDuca FM.  (2001) Evaluation of the Effect of Platelet GPIIb/IIIa Antagonist Eptifibatide on ACT and APTT Measured by the Point of Care HEMOCHRONÒ Jr. Signature.  Blood 2001; 98, 11.

• Bennett KM, Briggins D, Zucker ML, LaDuca FM. A Four-Year Experience With Patient Individualized Heparin and Protamine Dosing Using The Hemochron RxDx System. J Extra Corpor Technol 2001; 33:19-22.

• Fitch JCK, Mirto GP, Geary KL, Byrne DW, Hines RL.  Point-Of-Care and Standard laboratory Coagulation Testing During Cardiovascular Surgery: Balancing Reliability and Timeliness. J Clinical Monitoring and Computing 1999; 15: 197-204.

• LaDuca FM, Zucker ML, Walker CE.  Assessing Heparin Neutralization Following Cardiac Surgery: Sensitivity of Thrombin Time-Based Assays versus Protamine Titration Methods. Perfusion 1999; 14:181-87.

• Klein LW,  Agarwal JB.  When we “Act” on ACT Levels: Activated Clotting Time Measurements to Guide Heparin Administration During and After Interventional Procedures. Cathet Cardiovasc Diagn 1996; 37: 154-57.

• Narins CR, Hillegass WB, Jr, Nelson LC, Tchen JE, Harrington RA, Phillips HR, et al. Relation Between Activated Clotting Time During Angioplasty and Abrupt Closure. Circulation 1996; 93: 667-71.

• Ogilby JD, Kopelman HA, Klein LW,  Agarwal JB, MD.   Adequate Heparinization During PTCA: Assessment Using Activated Clotting Times. Cathet Cardiovasc Diagn 1989; 18: 202-9.

• Pan CM, Jobes D, Riper DV, Ogilby JD, Lin CY, Horrow J  et al.  Modified Microsample ACT Test For Heparin Monitoring. J Extra Corpor Technol 1996; 28: 16-20.

• Jobes DR, Aitken GL, Shaffer GW.  Increased Accuracy and Precision of Heparin and Protamine Dosing Reduces Blood Loss and Transfusion in Patients Undergoing Primary Cardiac Operations. J Thorac Cardiovasc Surg 1995; 110: P36-45.

• Zucker ML, Walker C, Jobes D, LaDuca FM.  Comparison of Celite and kaolin Based Heparin and protamine Dosing Assay During cardiac surgery: The in Vitro Effect of Aprotinin.  J Extra Corpor Technol 1995 Dec;  27:201-7.

-   Whole Blood Hemoglobin Testing System.

• El Rouby S,  Cesar K,  Takao T,  Hoshino C,  Franco RF, Rabelo R,  Zucker ML,  LaDuca FM Evaluation of a Novel Point of Care Hemoglobin Meter. Clin Chem 2003; 49:S6, P: A150, F-18.

• Patch, M.  Normal Range Performance with Hgb Pro, Hemocue® and Stat-Site® MHgb Using Fingerstick Samples.  ITC publications 2003.

• Patch M.  Interference of Bilirubin, Triglycerides, and Total Cholesterol Levels with the Hgb Pro Professional Hemoglobin Testing System™.  ITC publications 2003.

Journal Publications:  Blood Gases, Electrolytes and other Chemistries

• Toben B, Zucker ML:  Monitoring Hypoxia: One step beyond PaO2.  Neonatal Intensive Care.  2006; 19:4, 27-31.

• Toben B, Zucker ML:  The Importance of Liquid Quality Control.  POC. 2006; 5:2, 93.

• Toben B, Zucker ML:  Monitoring Hypoxia: One step beyond PaO2.  Resp Ther.  2006; 1:4, 25-29.

• Toben B, Zucker ML:  Arterial Blood Gases: Avoiding Preanalytical Errors to Improve Neonatal Assessment.  Resp Ther.  2006; 1:2, 14-17.

• Toben B, Zucker ML, LaDuca FM:  Arterial Blood Gas Assessment: Managing Accuracy Issues and Improving Patient Management.  Resp Ther.  2005; 1:1, 36-38

• Toben B, Zucker ML, LaDuca FM:  Arterial Blood Gas Assessment: Managing Accuracy Issues and Improving Patient Management.  Neonatal Intensive Care.  2005; 18:3, 45-47

Posters and Abstracts:  Blood Gases, Electrolytes and other Chemistries

• Toben  B, Goldsmith B, Nichols J, Toffaletti J, Zucker ML: Diagnostic Sensitivity of the IRMA TRUPoint Creatinine Assay.  Clin Chem, October 2006.

• Toben  B, Goldsmith B, Nichols J, Toffaletti J, Zucker ML: Diagnostic Sensitivity of the IRMA TRUPoint Creatinine Assay. AACC CPOCT Division's 21st International Symposium, Quebec, September 2006.

Abstracts:  Oximeter and CO-Oximeter (Click here to see Abstracts)

• Freeman, G.L., et al., Evaluation of Two Oximeters for Use in Cardiac Catheterization Laboratories. Catheterization and Cardiovascular Diagnosis 30: 51 - 57, 1993.

• Gong, A.K., Near-Patient Measurement of Methemoglobin, Oxygen Saturation, and Total Hemoglobin: Evaluation of a New Instrument for Adult and Neonatal Intensive Care. Critical Care Medicine 23: 193 - 201, 1995.

• Bailey, S.R., et al., Evaluation of the AVOXimeter: Precision, Long-term Stability, Linearity, and Use without Heparin. Journal of Clinical Monitoring 13:191 - 198, 1997.

• Shepherd, A.P., and J.M. Steinke. CO-Oximetry Interference by Perflubron Emulsion: Comparison of Hemolyzing and Non-hemolyzing Instruments. Clinical Chemistry 44: 2183 - 2190, 1998.

• Morales, R., M.B. Kirkpatrick, and P. Hoffman. Agreement in total hemoglobin and oxyhemoglobin and carboxyhemoglobin saturations between a point-of-care (AVOXimeter® 4000) and a standard (OSM3®) co-oximeters. Chest 118 (4 Suppl): 273S, 2000.

• Polito, F., et al. Electronic Archival and Compliance System for a Point-of-Care Instrument Not Connected to the Hospital Information System. Point of Care. Journal of Near-Patient Testing & Technology: 3:187-190, 2004.

• Shepherd, A.P., and C.A. McMahan. Role of oximeter error in the diagnosis of shunts. Catheterization and Cardiovascular Diagnosis 37: 435 - 446, 1996.

• Shepherd, A.P., J.M. Steinke, and C.A. McMahan. Effect of oximetry error on the diagnostic value of the Qp/Qs ratio. International Journal of Cardiology 61 (3): 247 - 259, 1997.

ITC Clinical Papers Download

• Bruce Toben, RRT-NPS, CPFT.  Pitfalls in the Measurement and Interpretation of Hemoglobin, Oxyhemoglobin Saturation and Oxygen Content in Point-of-Care Devices. Edison NJ, 2008

• Zucker ML, LaDuca FM.  Evolution Of A Point-Of-Care Coagulation System. 18th International AACC Point of Care & Critical Care Conference, Vol. Monterey, CA, 2002.

• D.R. Jobes, M.D.,  D.A. Etzioni, B.A., L.H. Stepsis, B.A., K.E. Dzien, B.A., Y.Choy, B.A., J. Mancini, B.A.  Cost Effective Management Of Heparin/Protamine In CP Bypass: Analysis By Type Of Surgery. American Society of Anesthesiology. New Orleans, LA, 1996.

• C. McMackin, K. Elliott, Bend Memorial Clinic, Bend, Oregon.  Start-Up And Implementation Of An Outpatient Clinic For Monitoring Oral Anticoagulation Therapy.  Anticoagulation Forum 1999 (ACF 1999)

• El Rouby S, Jaryno S, Zucker ML, LaDuca FM. Connectivity Solutions For A Point-Of-Care Microcoagulation System. 18th International AACC Point of Care & Critical Care Conference, Vol. Monterey, CA, 2002.

• Jaryno SA, Zucker ML, El Rouby S, Franks BLM, Nichols J, Anestis K, et al. Innovative Features Of A Point Of Care Coagulation Device And Data Manager: Results Of A Clinical Validation. 18th International AACC Point of Care & Critical Care Conference, Vol. Monterey, CA, 2002.

• Patch M, B.S.  Interference of Bilirubin, Triglycerides, and Total Cholesterol Levels with the Hgb Pro Professional Hemoglobin Testing System.  International Technidyne Corporation.  Edison, NJ, 2003.

• Patch M, B.S.  Normal Range Performance with Hgb Pro, Hemocue® and Stat-Site® MHgb Using Fingerstick Samples.  International Technidyne Corporation.  Edison, NJ, 2003.

• Internal and External Testing Of Thiopental Sodium and Propofol with the IRMA® Blood Analysis System.

• Bennett KM, Zucker ML, LaDuca FM.  Impact of Variable APTT Sensitivity on Monitoring Heparin Anticoagulation:  Evaluation Across Clinical Centers.  International Technidyne Corporation.  Edison, NJ, 2000. 

• Bennett KM, Zucker ML, LaDuca FM.  Identifying and Correcting Inter-Laboratory Variability of INR for Prothrombin Time Measurement.  International Technidyne Corporation.  Edison, NJ, 2000.

• Staikos L, Re RC, Fasholz JE, Zucker ML, LaDuca FM, Lee LV, Washington University School of Medicine, St. Louis, MO.  Improved Anticoagulation Management Using Point of Care Activated Partial Thromboplastin Time.  International Technidyne Corporation.  Edison, NJ, 2002.

• Porter E, Thomson R, Goldsmith BM, Dept. of Pathology, Univ. of Cincinnati College of Medicine, Cincinnati, Ohio.  An Evaluation of Point-of-Care Coagulation Systems.  Clinical Chemistry 48: A197-A198, 2002.

• Ovuworie C, Johnson M, Clark L, Irick J, Arrington M, Mouro JL, Zucker ML, Briefel G.  Efficacy of Hemochron® Jr. for ACT Monitoring in Combined Hemodialysis-Hemoperfusion.  Division of Nephrology, Johns Hopkins Bayview Medical Center, Baltimore, Maryland and International Technidyne Corporation, Edison, New Jersey, 2000.

• Technical Support, ITC.  Introducing our New “HE-LP” Service from ITC… International Technidyne Corporation.  Edison, New Jersey, 2002.

• Jaryno SA, Zucker ML, El Rouby S, Franks BLM, Nichols J, Anestis K, et al.  Innovative Features of a Point of Care Coagulation Device and Data Manager:  Results of a Clinical Validation.  18th International AACC Conference. Monterey, CA, 2002.