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Semin Thromb Hemost 2017; 43(04): 367-374
DOI: 10.1055/s-0037-1598062
Review Article
Thieme Medical Publishers 333 Seventh Avenue, New York, NY 10001, USA.

Point-of-Care Coagulation Monitoring in Trauma Patients

Philipp Stein
1   Institute of Anesthesiology, University and University Hospital Zurich, Zurich, Switzerland
,
Alexander Kaserer
1   Institute of Anesthesiology, University and University Hospital Zurich, Zurich, Switzerland
,
Gabriela H. Spahn
1   Institute of Anesthesiology, University and University Hospital Zurich, Zurich, Switzerland
,
Donat R. Spahn
1   Institute of Anesthesiology, University and University Hospital Zurich, Zurich, Switzerland
› Author Affiliations
Further Information

Publication History

Publication Date:
15 March 2017 (online)

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Abstract

Trauma remains one of the major causes of death and disability all over the world. Uncontrolled blood loss and trauma-induced coagulopathy represent preventable causes of trauma-related morbidity and mortality. Treatment may consist of allogeneic blood product transfusion at a fixed ratio or in an individualized goal-directed way based on point-of-care (POC) and routine laboratory measurements. Viscoelastic POC measurement of the developing clot in whole blood and POC platelet function testing allow rapid and tailored coagulation and transfusion treatment based on goal-directed, factor concentrate–based algorithms. The first studies have been published showing that this concept reduces the need for allogeneic blood transfusion and improves outcome. This review highlights the concept of goal-directed POC coagulation management in trauma patients, introduces a selection of POC devices, and presents algorithms which allow a reduction in allogeneic blood product transfusion and an improvement of trauma patient outcome.

Keywords

coagulation management - goal-directed algorithm - trauma-induced coagulopathy - point-of-care
 

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