[Coagulation therapy in multiple trauma without point-of-care testing]

Area of Science:

• Hematology
• Critical Care Medicine
• Point-of-Care Testing

Context:

• Limited availability of advanced hemostasis diagnostics like rotational thromboelastometry (ROTEM™), thrombelastography (TEG™), and Multiplate™ assays in German hospitals.
• Increased Grade of Recommendation (GoR 1C) for point-of-care (POC) testing in recent guidelines.
• The need for alternative strategies when POC testing is unavailable.

Purpose:

• To highlight the importance of advanced hemostasis analysis in managing trauma-induced coagulopathy.
• To discuss alternatives to POC testing, including blood products and coagulation factor concentrates.
• To emphasize the role of adequate transfusion strategies and factor administration in optimizing outcomes for multiply traumatized patients.

Summary:

• Advanced hemostasis diagnostics (ROTEM™, TEG™, Multiplate™) are not widely accessible in Germany.
• Coagulation factor concentrates offer benefits over blood products, including reduced side effects and faster action.
• Effective management of trauma-induced coagulopathy requires a comprehensive approach involving transfusion and factor replacement.

Impact:

• Improved patient outcomes in multiply trauma cases through timely and appropriate interventions.
• Reduced immunological and infection-related complications associated with factor concentrate therapy.
• Potential for wider adoption of advanced hemostasis testing and targeted therapies in critical care settings.