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Inr normal range 48/17/2023 ![]() In 1988, to prevent this condition, a protocol of three oral doses of vitamin K, 2 mg each, was recommended for all full-term neonates these are given on the day of birth, upon discharge from the maternity hospital, and at 1 month of age. In Japan, a nation-wide survey in 1981, before vitamin K prophylaxis was recommended, revealed that 7.1 cases of VKDB occurred per 100,000 births. The incidence of VKDB in infants without prophylaxis has been reported to range from 4.4 to 10.5 per 100,000 live births in Asia and Europe. Neonatal vitamin K deficiency bleeding (VKDB) causes digestive tract bleeding in the early neonatal period and intracranial hemorrhage in early infancy. Our study is the first to establish a RI for INRs that were measured using the CoaguChek XS in healthy term neonates. ![]() The CoaguChek XS device is safe, fast, and convenient for performing INR assays in neonates. The INR was found to correlate with gestational age, birth weight, and hematocrit value. A significant difference in the INR was noted between male (median value, 1.10 RI, 0.90–1.30) and female (median value, 1.10 RI, 0.90–1.24) neonates (p = 0.049). A RI for INRs in 4-day-old neonates was established using the CoaguChek XS with a median value of 1.10 and a range of 0.90–1.30. The enrolled neonates were orally administered vitamin K 6-12 h after birth. The INRs determined by CoaguChek XS were measured in 4-day-old neonates. This study included 488 healthy term neonates born at a perinatal center between July 2012 and June 2013. The objectives of the present study were to determine the reference intervals (RIs) for international normalized ratio (INR) using the CoaguChek XS by capillary puncture in healthy term neonates, to evaluate factors that correlate with INR, and to evaluate the device by assessing its ease of use in clinical practice. Although the device is used in adults and children, studies have not been performed to evaluate its clinical utility in neonates, and the reference value is unknown in this population. CoaguChek XS is a portable device designed to monitor prothrombin time while only drawing a small volume of blood. However, venous access and the volume of blood required for such testing can be problematic. A coagulation screening test might be necessary to detect prophylactic failure or incomplete prophylaxis. ![]() The INR value from POCT is considered acceptable if it does not exceed plus or minus 0.5 INR units by the reference laboratory INR value.Neonates routinely receive vitamin K to prevent vitamin K deficiency bleeding, which is associated with a high mortality rate and a high frequency of neurological sequelae. On the other hand, capillary whole blood can be obtained from POC-PT systems by a fingerstick which is then applied to a test strip or cartridge. Providers should be vigilant if the specimen is taken from a vascular-assisted device because there may be possible heparin contamination that may interfere with INR reliability. The total time between sample collection and testing should not exceed 24 hours. The tube should be then inverted a few times, gently and as soon as possible, for proper mixing with the anticoagulant. The tubes must be filled to within 90% of the full collection volume. The acceptable anticoagulant is the concentration of sodium citrate 3.2%. It is recommended by the Clinical and Laboratory Standard Institutes (2017) that the blood specimens for INR/PT testing in the laboratory setting should be collected from venous blood and it is directly obtained into a tube with a light blue top. In additon, apart from adherence and treatment satisfaction some patient found to be more anxious about the PT/INR monitoring. Patient with antiphospholipid antibodies have been found to have higher error rate in INR determination. However, POC devices tend to overestimate low INR values and underestimate high INR values. Potential advantages of POC devices include improved convenience to patients, better treatment adherence, frequent measurement and fewer thromboembolic and bleeding complications. It can be performed at or near the patients with the advantage of shorter turnaround time and improved clinical outcome. POC devices are used in practitioner offices, long-term care facilities, pharmacies, or for patient self-testing or self-management. However, given the higher CCT turnaround time including collection, transportation, and processing of blood samples, Point-of-care coagulation test (POCT) also known as “bedside testing” or “near-patient testing" has been developed. Conventional coagulation testing (CCT) can be performed in the laboratory setting to measure PT/INR.
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