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[Role of the clinical laboratory for patients with massive transfusion undergoing elective surgery]
Shuichi Kino1, Susumnu Takenaka, Noriyasu Niizeki
1Department of Medical Laboratory and Blood Center, Asahikawa Medical University Hospital, Asahikawa 078-8510, Japan. skino@asahikawa-med.ac.jp
The microvascular bleeding resulting from the dilutional coagulopathy can occur when patients with massive blood loss are treated by infusing a lot of crystalloids, colloids, and red blood cell concentrates. For the management of dilutional coagulopathy and the appropriate replacement therapy of with coagulation factors and platelets, we usually monitor the patient's course of with platelet count, conventional coagulation tests such as the prothrombin time, the activated partial prothrombin time, and the fibrinogen concentration. The central clinical laboratory has a responsibility for an accurate and quick report of these test results of patients with massive transfusion. Furthermore, use of point care testing is of clinical value to fulfill a clinical demand in case with dilutional coagulopathy.
The microvascular bleeding resulting from the dilutional coagulopathy can occur when patients with massive blood loss are treated by infusing a lot of crystalloids, colloids, and red blood cell concentrates. For the management of dilutional coagulopathy and the appropriate replacement therapy of with coagulation factors and platelets, we usually monitor the patient's course of with platelet count, conventional coagulation tests such as the prothrombin time, the activated partial prothrombin time, and the fibrinogen concentration. The central clinical laboratory has a responsibility for an accurate and quick report of these test results of patients with massive transfusion. Furthermore, use of point care testing is of clinical value to fulfill a clinical demand in case with dilutional coagulopathy.
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