Point-of-Care Coagulation Testing

There are three different methods to analyze blood coagulation at the patient’s bedside (i.e., point of care, or POC). The first includes simple anticoagulation monitoring devices: activated clotting time (ACT), whole blood PT/INR and whole blood aPTT. These are being used for perioperative anticoagulant management and can be helpful in massively bleeding patients known to be on heparin therapy or vitamin K antagonists. Secondly, there are several POC coagulation tests available to assess primary hemostasis and platelet function (e.g., PFA-100/200 and modified platelet aggregometry). These bedside tests are most useful in the setting of antiplatelet therapy. Lastly, there are viscoelastic coagulation monitoring devices such as thromboelastography (TEG^®; Haemonetics Corp., formerly Haemoscope Corp., Braintree, MA), rotational thromboelastometry (ROTEM^®, Tem International GmbH, formerly Pentapharm GmbH, Munich, Germany) and Sonoclot^® (Sonoclot Coagulation & Platelet Function Analyzer, Sienco Inc., Arvada, CO). These viscoelastic coagulation tests rapidly (five-30...