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
