Point-of-care monitoring for the management of trauma-induced bleeding

Curr Opin Anaesthesiol. 2017 Apr;30(2):250-256. doi: 10.1097/ACO.0000000000000448.

Abstract

Purpose of review: Knowledge of trauma-induced coagulopathy has been grown in the past and point-of-care suitable devices for coagulation testing have been introduced. Methodology and clinical application of different systems for point-of-care coagulation monitoring are shown with a focus on thrombelastography as measured by TEG, rotational thromboelastometry as measured by ROTEM and impedance aggregometry as measured by the multiplate analyser and ROTEM platelet.

Recent findings: Two different methods for point-of-care coagulation assessment are available: viscoelastic tests (ROTEM, TEG) and impedance aggregometry. In different settings these methods have been evaluated in various publications pointing out the possibility of reducing transfusion requirements, transfusion-related side effects, and resulting costs.

Summary: Point-of-care assessment of coagulation in trauma patients appears to be at least promising. However, because published data mostly are of retrospective or observational nature only, there is a need for prospective, randomized and controlled studies.

Publication types

  • Review

MeSH terms

  • Blood Coagulation Disorders / diagnosis*
  • Blood Coagulation Disorders / etiology
  • Blood Coagulation Tests / instrumentation
  • Blood Coagulation Tests / methods*
  • Blood Transfusion
  • Hemorrhage / diagnosis
  • Hemorrhage / etiology
  • Hemorrhage / therapy*
  • Humans
  • Monitoring, Physiologic / instrumentation
  • Monitoring, Physiologic / methods*
  • Point-of-Care Systems*
  • Wounds and Injuries / complications*
  • Wounds and Injuries / therapy