Perioperative bleeding disorder and intraoperative ponit-of-care testing of coagulation during cardiac surgery

Kim, Tae Yop

Review

Cardiothoracic and Vascular Anesthesia

Anesthesia and Pain Medicine 2011;6(1):1-15.
Published online January 31, 2011.

Perioperative bleeding disorder and intraoperative ponit-of-care testing of coagulation during cardiac surgery

Tae Yop Kim

Department of Anesthesiology and Pain Medicine, Konkuk University Medical Center, Seoul, Korea. taeyop@kuh.ac.kr

Abstract

Cardiac surgery is frequently associated with an excessive perioperative blood loss requiring transfusion of blood products. Various point-of-care(POC) assessments for coagulation and platelet function allow an appropriate and, targeted therapy and reduce blood loss and transfusion requirements. In particular, a quick evaluation of platelet and coagulation defects with new POC devices can optimize the administration of pharmacological and transfusion-based therapy in cardiac surgery. The main advantages of POC tests are shorter time delay, assessment in whole blood and patient's temperature, potential to measure entire clotting process and to include information of platelet function. A transfusion algorithm using POC tests showed effectiveness in reducing intraoperative bleeding and transfusion requirements. Standardized procedure, strict quality control and trained personnel are highly recommended for optimal accuracy and performance of POC tests.

Key Words: Cardiac surgery, Coagulation, Point-of-care test