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Point-of-Care Coagulation Monitoring

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Monitoring Technologies in Acute Care Environments

Abstract

Blood coagulation is a complex and tightly regulated physiological network of interacting proteins, cells, and cofactors with multiple amplification and control pathways. The system represents a delicate balance between pro- and anticoagulant and pro- and antifibrinolytic activities. Out of balance, clinically relevant phenotypes (i.e., bleeding and thrombosis) occur and may dramatically influence patients’ outcome.

Current coagulation management and transfusion strategies are based on understanding of the coagulation physiology and specific diagnostic tools. Point-of-care (POC) coagulation monitoring helps to reliably and readily identify the underlying coagulation disorder. With this information, patients can be treated according to their individual needs following goal-directed and clearly defined algorithms.

There are several POC methods available to analyze blood coagulation. According to their main objective and function, POC coagulation analyzers can be categorized into devices focusing on the analysis of primary (cellular), secondary (plasmatic), or the entire hemostasis, from initial thrombin generation to maximum clot formation up to fibrinolysis.

This chapter presents currently available POC coagulation analyzers, discusses their indications and limitations, and shows how POC coagulation monitoring may contribute to improved clinical outcomes.

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Author information

Authors and Affiliations

  1. Institute of Anesthesiology and Pain Medicine, Kantonsspital Winterthur, Brauerstrasse 15, Postfach 834, Winterthur, 8401, Switzerland

    Michael T. Ganter MD, DEAA

  2. Institute of Anesthesiology and Intensive Care Medicine, Triemli City Hospital Zurich, Birmensdorferstr. 497, Zurich, 8063, Switzerland

    Christoph K. Hofer MD, DEAA

Authors
  1. Michael T. Ganter MD, DEAA
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  2. Christoph K. Hofer MD, DEAA
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Corresponding author

Correspondence to Christoph K. Hofer MD, DEAA .

Editor information

Editors and Affiliations

  1. Departments of Anesthesiology, Surgery, and Biomedical Informatics, Vanderbilt University School of Medicine, Nashville, Tennessee, USA

    Jesse M. Ehrenfeld

  2. Department of Anesthesiology and Perioperative Care, University of California, Irvine, Irvine, California, USA

    Maxime Cannesson

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Ganter, M.T., Hofer, C.K. (2014). Point-of-Care Coagulation Monitoring. In: Ehrenfeld, J., Cannesson, M. (eds) Monitoring Technologies in Acute Care Environments. Springer, New York, NY. https://doi.org/10.1007/978-1-4614-8557-5_40

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  • DOI: https://doi.org/10.1007/978-1-4614-8557-5_40

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  • Publisher Name: Springer, New York, NY

  • Print ISBN: 978-1-4614-8556-8

  • Online ISBN: 978-1-4614-8557-5

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