Point-of-Care INR Measurement in Children Requiring Warfarin: What has been Evaluated and Future Directions

Abstract

Many children are surviving primary illnesses and now require thromboprophylaxis as a result of advances in management. Vitamin K antagonists are commonly prescribed to prevent or treat thrombosis. These agents are far more challenging to effectively manage in children. As a result of these challenges, frequent blood monitoring to measure international normalized ratio (INR) values is required. Point-of-care (POC) INR monitors use a capillary blood sample that has been expressed as a solution to improve effective management of vitamin K antagonist therapy. POC INR meters have been demonstrated to be accurate and precise in measuring INRs. Implementation of a standardized education program prior to patient use of POC meters results in differences between measured laboratory INRs and POC INR comparisons that meet criteria for clinical relevance. This indicates that POC INR meters are safe and effective for use in children.