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The surgical application of point‐of‐care haemostasis and platelet function testing. BJS 2008; 95: 1317-1330.

Published: 9th October 2008

Authors: K. J. Dickinson, M. Troxler, S. Homer‐Vanniasinkam

Background

Disordered coagulation complicates many diseases and their treatments, often predisposing to haemorrhage. Conversely, patients with cardiovascular disease who demonstrate antiplatelet resistance may be at increased thromboembolic risk. Prompt identification of these patients facilitates optimization of haemostatic dysfunction. Point‐of‐care (POC) tests are performed ‘near patient’ to provide a rapid assessment of haemostasis and platelet function.

Method

This article reviews situations in which POC tests may guide surgical practice. Their limitations and potential developments are discussed. The paper is based on a Medline and PubMed search for English language articles on POC haemostasis and platelet function testing in surgical practice.

Results

POC tests identifying perioperative bleeding tendency are already widely used in cardiovascular and hepatic surgery. They are associated with reduced blood loss and transfusion requirements. POC tests to identify thrombotic predisposition are able to determine antiplatelet resistance, predicting thromboembolic risk. So far, however, these tests remain research tools.

Conclusion

POC haemostasis testing is a growing field in surgical practice. Such testing can be correlated with improved clinical outcome. Copyright © 2008 British Journal of Surgery Society Ltd. Published by John Wiley & Sons, Ltd.

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