Point-of-Care Coagulation Management in Intensive Care Medicine

Meybohm, Patrick; Zacharowski, Kai; Weber, Christian Friedrich

doi:10.1007/978-3-642-35109-9_33

Cited by 21 publications

(25 citation statements)

References 43 publications

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“…Several whole blood point-of care tests have been demonstrated to be valuable tools in different clinical settings including critical care facilities [83]. The potential advantages of these tests are rapid turnaround time, simplified workflows, and targeted management of coagulation disorders.…”

Section: Impedance Aggregometrymentioning

confidence: 99%

Anti-platelet Therapy Resistance – Concept, Mechanisms and Platelet Function Tests in Intensive Care Facilities

Mărginean

Bănescu

Scridon

et al. 2016

The Journal of Critical Care Medicine

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It is well known that critically ill patients require special attention and additional consideration during their treatment and management. The multiple systems and organ dysfunctions, typical of the critical patient, often results in different patterns of enteral absorption in these patients. Anti-platelet drugs are the cornerstone in treating patients with coronary and cerebrovascular disease. Dual anti-platelet therapy with aspirin and clopidogrel is the treatment of choice in patients undergoing elective percutaneous coronary interventions and is still widely used in patients with acute coronary syndromes. However, despite the use of dual anti-platelet therapy, some patients continue to experience cardiovascular ischemic events. Recurrence of ischemic events is partly attributed to the fact that some patients have poor inhibition of platelet reactivity despite treatment. These patients are considered low-or nonresponders to therapy. The underlying mechanisms leading to resistance are not yet fully elucidated and are probably multifactorial, cellular, genetic and clinical factors being implicated. Several methods have been developed to asses platelet function and can be used to identify patients with persistent platelet reactivity, which have an increased risk of thrombosis. In this paper, the concept of anti-platelet therapy resistance, the underlying mechanisms and the methods used to identify patients with low responsiveness to anti-platelet therapy will be highlighted with a focus on aspirin and clopidogrel therapy and addressing especially critically ill patients.

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Section: Impedance Aggregometrymentioning

confidence: 99%

Anti-platelet Therapy Resistance – Concept, Mechanisms and Platelet Function Tests in Intensive Care Facilities

Mărginean

Bănescu

Scridon

et al. 2016

The Journal of Critical Care Medicine

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“…TEG is unable to provide information such as a platelet count, so the combination of aggregometric and viscoelastic methods is recommended for completeness. [15].…”

Section: Limitations Of Tegmentioning

confidence: 95%

Review of Thromboelastography in Neurocritical Care

et al. 2015

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“…In this respect, the use of a coagulation algorithm is recommended [75,76]. In addition, basic conditions for hemostasis (eg, temperature, calcium, pH), reversal of anticoagulants, point-of-care diagnostics in coagulopathic patients, optimized coagulation management with the use of clotting factor concentrates, and the (empiric) use of antifibrinolytic agents or desmopressin are further important considerations [40,60,77,78]. The one-size-fits-all dogma of fresh frozen plasma (FFP) transfusion to correct or prevent coagulopathy needs be critically questioned due to known risks of allogeneic blood products [40].…”

Section: Hemostasis Management In Hospitalized Patientsmentioning

confidence: 99%

Patient Blood Management Bundles to Facilitate Implementation

Meybohm

Richards

Isbister

et al. 2017

Transfusion Medicine Reviews

181

117

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More than 30% of the world's population are anemic with serious economic consequences including reduced work capacity and other obstacles to national welfare and development. Red blood cell transfusion is the mainstay to correct anemia, but it is also 1 of the top 5 overused procedures. Patient blood management (PBM) is a proactive, patient-centered, and multidisciplinary approach to manage anemia, optimize hemostasis, minimize iatrogenic blood loss, and harness tolerance to anemia. Although the World Health Organization has endorsed PBM in 2010, many hospitals still seek guidance with the implementation of PBM in clinical routine. Given the use of proven change management principles, we propose simple, cost-effective measures enabling any hospital to reduce both anemia and red blood cell transfusions in surgical and medical patients. This article provides comprehensive bundles of PBM components encompassing 107 different PBM measures, divided into 6 bundle blocks acting as a working template to develop institutions' individual PBM practices for hospitals beginning a program or trying to improve an already existing program. A stepwise selection of the most feasible measures will facilitate the implementation of PBM. In this manner, PBM represents a new quality and safety standard.

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Point-of-Care Coagulation Management in Intensive Care Medicine

Cited by 21 publications

References 43 publications

Anti-platelet Therapy Resistance – Concept, Mechanisms and Platelet Function Tests in Intensive Care Facilities

Anti-platelet Therapy Resistance – Concept, Mechanisms and Platelet Function Tests in Intensive Care Facilities

Review of Thromboelastography in Neurocritical Care

Patient Blood Management Bundles to Facilitate Implementation

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