Point-of-care coagulation management in intensive care medicine

Excerpt

Coagulopathy in critically ill patients is common and of multifactorial origin [1]. Coagulopathy-associated risk of bleeding and the use of allogeneic blood products are independent risk factors for morbidity and mortality [2, 3]. Therefore, prompt and correct identification of the underlying causes of these coagulation abnormalities is required, since each coagulation abnormality necessitates very different therapeutic management strategies. Standard laboratory tests of blood coagulation yield only partial diagnostic information, and important coagulation defects, e.g., reduced clot stability, platelet dysfunction, or hyperfibrinolysis, remain undetected. Therefore, point-of-care (POC) diagnostics are increasingly being used for rapid specific testing of hemostatic function. Algorithm-based hemotherapy, including POC techniques, reliably corrects coagulopathy, but may also have the potential to reduce blood loss, transfusion requirements and risk of transfusion-related adverse events, prevent thromboembolic events, and save costs. …