Prehospital Coagulation Monitoring of Resuscitation With Point-of-Care Devices.

Research output: Contribution to journalReview articlepeer-review

12 Citations (SciVal)

Abstract

A variety of Point-Of-Care monitors for the measurement of hematocrit, hemoglobin, blood gas with electrolytes and lactate can be used also in the prehospital setting for optimizing and individualizing trauma resucitation. Point-Of-Care coagulation testing with activated prothrombin test, prothrombin test and activated coagulation/clotting time tests are available for prehospital use. Although robust, battery driven and easy to handle, many devices lack documentation for use in prehospital care. Some of the devices correspond poorly to corresponding laboratory analyses in acute trauma coagulopathy and at lower hematocrits. In trauma, viscoelastic tests like rotational thromboelastometry and thromboelastography can rapidly detect acute trauma coagulopathy and give an overall dynamic picture of the hemostatic system and the interaction between its different components: coagulation activation, fibrin polymerization, fibrin platelet interactions within the clot and fibrinolysis. Rotational thromboelastometry is shock resistant and has the potential to be used outside the hospital setting to guide individualized coagulation factor and blood component therapies. Sonoclot® and Rheorox® are two small size viscoelastic instruments with one channel options, but with less documentation. The Point-Of-Care market for coagulation tests are quickly expanding and new devices are introduced all the time. Still they should be better adopted to prehospital conditions, be small, robust, battery charged, rapid, use small sample volumes and whole blood.
Original languageEnglish
Pages (from-to)26-29
JournalShock
Volume41
Issue numberDec 20
DOIs
Publication statusPublished - 2014

Subject classification (UKÄ)

  • Anesthesiology and Intensive Care

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