[Point-of-care testing of hemostatic alterations in anaesthesia and intensive care]

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.