Abstract
This review provides a comprehensive and up-to-date overview of point-of-care (POC) devices most commonly used for coagulation analyses in the acute settings. Fast and reliable assessment of hemostasis is essential for the management of trauma and other bleeding patients. Routine coagulation assays are not designed to visualize the process of clot formation, and their results are obtained only after 30–90 m due to the requirements of sample preparation and the analytical process. POC devices such as viscoelastic coagulation tests, platelet function tests, blood gas analysis and other coagulometers provide new options for the assessment of hemostasis, and are important tools for an individualized, goal-directed, and factor-based substitution therapy. We give a detailed overview of the related tests, their characteristics and clinical implications. This review emphasizes the evident advantages of the speed and predictive power of POC clot measurement in the context of a goal-directed and algorithm-based therapy to improve the patient’s outcome. Interpretation of viscoelastic tests is facilitated by a new visualization technology.
Highlights
Severe bleeding, e.g., after trauma or during surgery, requires adequate coagulation management [1]
The results must be interpreted with caution since they are altered by several factors, such as coagulation factor-deficiency including fibrinogen deficiency, impaired liver function, vitamin K deficiency or consumption coagulopathy [100]
Coagulation management is based on a reliable assessment of the hemostasis, which may be compromised by trauma-induced coagulopathy, of antithrombotic therapy or of other coagulopathies and during surgery
Summary
E.g., after trauma or during surgery, requires adequate coagulation management [1]. Because of the processes of sample preparation and centrifugation, analysis and validation prothrombin time (aPTT) or thrombin time (TT) are not designed to visualize the process of clot of the results standard laboratory results are available only after 30–90 m [10] or even later They are formation or clot stability [3]. Because of the processes of sample preparation and of limited analysis value forand coagulation in the initial acute phase, if repetitive centrifugation, validation management of the results standard laboratory results especially are available only analyses needed [11]. Aclot faster alternativeclot is POC and clot lysis in real-time, to evaluate fortests, a possible oftests oraland anticoagulants platelet assays, which include viscoelastic coagulation plateletintake function coagulometers.orThey allow the assessment of clot formation, clot stability and clot lysis in real-time, to evaluate for a inhibitors. Available POC devices, and focuses on the most widely available and commonly used tests
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