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The surgical application of point-of-care haemostasis and platelet function testing

Dickinson, KJ; Troxler, M; Homer-Vanniasinkam, S; (2008) The surgical application of point-of-care haemostasis and platelet function testing. BRIT J SURG , 95 (11) 1317 - 1330. 10.1002/bjs.6359.

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Abstract

Background: Disordered coagulation complicates many diseases and their treatments, often predisposing to haemorrhage. Conversely, patients with cardiovascular disease who demonstrate antiplatelet resistance may be at increased thromboembolic risk. Prompt identification of these patients facilitates optimization of haemostatic dysfunction. Point-of-care (POC) tests are performed 'near patient' to provide a rapid assessment of haemostasis and platelet function.Methods: This article reviews situations in which POC tests may guide surgical practice. Their limitations and potential developments are discussed. The paper is based on a Medline and PubMed search for English language articles on POC haemostasis and platelet function testing in surgical practice.Results: POC tests identifying perioperative bleeding tendency are already widely used in cardiovascular and hepatic surgery. They are associated with reduced blood loss and transfusion requirements. POC tests to identify thrombotic predisposition are able to determine antiplatelet resistance, predicting thromboembolic risk. So far, however, these tests remain research tools.Conclusion: POC haemostasis testing is a growing field in surgical practice. Such testing can be correlated with improved clinical outcome.

Type:Article
Title:The surgical application of point-of-care haemostasis and platelet function testing
DOI:10.1002/bjs.6359
Keywords:PERCUTANEOUS CORONARY INTERVENTION, ACTIVATED CLOTTING TIME, BLOOD HEPARIN CONCENTRATION, HIGH-RISK PATIENTS, CARDIOPULMONARY BYPASS, CARDIAC-SURGERY, ANTIPLATELET THERAPY, ASPIRIN RESISTANCE, LIVER-TRANSPLANTATION, ARTERY-DISEASE
UCL classification:UCL > School of Life and Medical Sciences > Faculty of Medical Sciences > Surgery and Interventional Science (Division of)

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