Essay on Point-of-Care Coagulation Platforms for Thrombophilia
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Thrombophilia defines inherited and acquired conditions associated with an increased thrombotic risk, which predispose to venous thromboembolism (VTE), cardiopulmonary bypass (CPB) and stroke. Thromboembolic events have long been treated with the most commonly used anticoagulant drug, heparin that is rapidly replaced by low molecular weight heparin (LMWH). A variety of point-of-care (POC) coagulation platforms have been commercially available for many years now, providing more control over the patient’s anticoagulation management such as heparin and warfarin. While the measurement for anticoagulation by POC devices has relied mainly on the clotting time tests, innovative platelet function tests, and factor-specific assays based on…show more content… While the prevention of a thrombotic event achieved by an anticoagulant, over- or under-dosing can give rise to excessive bleeding or severe clotting respectively, therefore closely link therapy with monitoring is essential. Several techniques have been developed to address the disadvantages of large sample volumes, by multiplexing of the assays in which various parameters or analytes are measured concurrently from a single sample.
While laboratories became unable to provide results in time frames needed to allow rapid turnaround that would allow timely intervention of anticoagulant therapy, the requirement for POC coagulation monitoring techniques became essential (Harris, Castro-López and Killard, 2013).
In this review, I will focus on the availability of POC diagnostic tests for monitoring the anticoagulant therapy for thrombophilia. I will first describe the conventional clot-based assays and then, I will attempt to address current advances in microfluidic POC tests used for monitoring thromboembolic-related events and highlight new fluorescence-based anti-Factor Xa (FXa) microfluidic POC assay platform for monitoring both unfractionated and low molecular weight heparins and fluorescence-based blood coagulation assay platform for monitoring activated partial thromboplastin time (aPTT). Also, I will