[Perioperative hemostasis management]

Hemostasis management plays an important role in surgery. Anti-platelet drugs and oral anticoagulants are taken by an increasing number of patients. Perioperative management must take into account bleeding as well as thromboembolic risks when withholding these medications. Patients with inherited or acquired hemostatic disorders should receive interdisciplinary care in order to optimise perioperative substitution therapy. For the diagnosis of acquired coagulopathy secondary to massive bleeding, point of care tests have been introduced that should help focus substitution therapy in emergency situations. However, physicians should be aware of the limitations of these methods, and a full diagnostic workup should be done in order to uncover hemorrhagic diatheses not detected by point of care testing.