Patientennahe Sofortdiagnostik von H�mostasever�nderungen in der An�sthesie und Intensivmedizin

Abstract

In recent years point-of-care testing (POCT) has seen wider applications in the clinical management of surgical and critically ill patients. The available methods for haemostasis analysis include simple-to-handle tests for the assessment of plasmatic coagulation, platelet function tests and the more complex visco-elastic assays. The main advantage of POCT is the fast availability of the results allowing a targeted management of haemostasis disorders. The benefits and risks of POCT depend on the urgency of the analysis, the turn-around time of the laboratory tests, the availability of motivated staff at the point-of-care and the expected haemostatic alterations. An underestimated aspect of POCT is the importance of established quality management procedures. For this purpose control materials based on plasma or artificial fluids are being applied. In spite of often higher costs we appraise the use of POC analysis in many settings as justified because of the gain of time and the overall better process quality, i.e. targeted haemostasis therapy instead of consecutive application of different therapeutic options.

Vascular type Ehlers-Danlos syndrome is associated with platelet dysfunction and low vitamin D serum concentration

“…The ROTEM® is a haemostasis analyzer, that measures kinetic changes of the clot elasticity of whole blood samples [ 17 ]. It is provided by the TEM group (Basel, Switzerland) ( http://www.rotem.de/en ) and allows quantitative and qualitative assessment by measuring different parameters of the clot status of the blood sample.…”

Perioperative Coagulation Management and Control of Platelet Transfusion by Point-of-Care Platelet Function Analysis

“…However, their turnaround time makes laboratory-based methods impractical for concurrent coagulation management of patients during surgery [2]. Point-of-care (POC) tests enable contemporary and targeted therapy of coagulation disorders [3,4]. Coupled with algorithms for coagulation management, the use of POC tests may be able to reduce transfusion requirements, re-exploration rates and costs [1,5,6].…”

Messung der Thrombozytenfunktion mit Point-of-Care-Methoden

“…Gerade in diesen Situationen, aber auch zur Kontrolle der Effektivität einer Therapie mit Thrombozytenaggregationshemmern können Point-of-Care-(POC-)Methoden zur Erfassung der Thrombozytenfunktion eine wesentliche Entscheidungshilfe für den Kardiologen und Anästhesisten sein. Sie unterscheiden sich von den ansonsten eher technisch aufwendigen Methoden der Thrombozytenfunktionsanalytik dadurch, dass sie mit geringem technischen Aufwand bedsidemäßig im Operationssaal oder auch in der kardiologischen Praxis mit einer Vollblutprobe durchgeführt werden können [3,21]. Basierend auf diesen POC-Methoden, haben wir Algorithmen zum perioperativen Gerinnungsmanagement in der Viszeral-und Transplantationschirurgie, Traumatologie und kardiovaskulären Chirurgie entwickelt [16,17].…”