Point-of-care coagulation testing and transfusion algorithms

• Published in: British journal of anaesthesia : BJA Vol. 103; no. suppl-1; pp. i14 - i22
• Main Authors: Enriquez, L.J., Shore-Lesserson, L.
• Format: Journal Article
• Language: English
• Published: England Elsevier Ltd 01-12-2009; Oxford University Press
• Subjects: Algorithms; anticoagulants; blood; Blood Coagulation Disorders - diagnosis; Blood Coagulation Tests - methods; Blood Transfusion; blood, anticoagulants; blood, anticoagulants, heparin; blood, coagulation; blood, platelets; Cardiac Surgical Procedures; coagulation; heparin; Humans; measurement techniques; measurement techniques, coagulation; measurement techniques, thrombelastograph; Monitoring, Physiologic - methods; Perioperative Care - methods; Platelet Function Tests - methods; platelets; Point-of-Care Systems; thrombelastograph; transfusion; blood, anticoagulants, heparin; blood, platelets; blood, transfusion; measurement techniques, thrombelastograph; blood, anticoagulants; measurement techniques, coagulation; blood, coagulation
• ISSN: 0007-0912; 1471-6771
• DOI: 10.1093/bja/aep318

Patients with cardiovascular disease have an array of haemostasis disorders that predispose to the development of thrombotic and embolic disease states. These patients are often maintained on anti-thrombotic medication to prevent adverse cardiovascular events. Patients undergoing cardiac surgery also have haemostatic disorders that include their intrinsic disease state, adjunctive medication, and the coagulation disturbances induced by cardiopulmonary bypass. The following review introduces the monitors that are available for monitoring perioperative coagulation, with an emphasis on cardiovascular surgery. Heparin monitors, platelet function monitors for use in transfusion algorithms, and monitoring anti-platelet drugs will be discussed.