Perioperative coagulation monitoring is the rational diagnostic basis for pro- and anti-thrombotic interventions in patients undergoing emergency and elective surgery. The main goal of perioperative monitoring of haemostasis is to increase safety of patients undergoing surgical procedures.
Currently, there is a change in paradigm with (1) increasing implementation of evidence-based approach to preoperative patient evaluation with laboratory coagulation testing secondary to the results of the standardised bleeding history and (2) awareness of the limitations of routine coagulation tests to guide coagulation management in massive bleeding. Alternatively, visco-elastic point-of-care monitoring is increasingly used worldwide. This innovative methodology triggers a trend towards an ‘early goal-directed coagulation management’ focussing on potent coagulation factor concentrates. Practicability, cost-effectiveness, safety and – above all – growing scientific evidence support this concept, and lively discussions among anaesthesiologists and various medical disciplines may help to refine it. The present review focusses on the following key issues of perioperative coagulation monitoring:
aDepartment of Anaesthesiology, General Intensive Care und Pain Management, Vienna Medical University, Währinger Gürtel 18-20, 1090 Vienna, Austria
bDepartment of Anaesthesia and Intensive Care, Evangelisches Krankenhaus Wien, Hans Sachs-Gasse 10-12, 1180 Vienna, Austria
Department of Anaesthesiology, General Intensive Care und Pain Management, Vienna Medical University, Währinger Gürtel 18-20, 1090 Vienna, Austria. Tel.: +43 1 40400 4144; Fax: +43 1 40400 4165.
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