title: Perioperative coagulation management during cardiac surgery.
abstract: OBJECTIVE
  Cardiac surgery patients commonly present bleeding complications that negatively influence patient's clinical outcome. Therefore, fast and detailed diagnoses as well as early and specific therapy of perioperative coagulopathy are of high clinical relevance. The so-called point-of-care (POC) methods for coagulation analyses are increasingly used in perioperative care. It is the purpose of this review to present modern aspects of coagulation management, discuss the effect of the implementation of POC methods in perioperative care, and present substantial components of hemotherapy algorithms to manage coagulopathy in cardiac surgery patients.
  
  
  RESULTS
  Recent studies suggest that implementation of point-of-care testing in hemotherapy algorithms which inclose stepwise therapeutic escalation may reduce perioperative blood loss and the transfusion rate of allogenic blood products. This should improve patient's clinical outcome and reduce costs.
  
  
  CONCLUSIONS
  Prospective randomized multicenter studies are needed to confirm the hypothesis that algorithm-based specific hemotherapy in conjunction with POC testing minimizes patient's exposure to blood products and improves clinical outcome.
authors.affiliation: Clinic of Anesthesiology, Intensive Care Medicine and Pain Therapy, Goethe-University Hospital Frankfurt, Theodor-Stern-Kai, Frankfurt am Main, Germany. Christian.Weber@kgu.de
authors.forename: Christian F
authors.initials: CF
authors.lastname: Weber
authors.forename: Matthias
authors.initials: M
authors.lastname: Klages
authors.forename: Kai
authors.initials: K
authors.lastname: Zacharowski
mesh_terms: D001777:Blood Coagulation; D016063:Blood Loss, Surgical; D006348:Cardiac Surgical Procedures / Q000379:methods*; D006801:Humans; D007430:Intraoperative Care / Q000379:methods; D007431:Intraoperative Complications / Q000517:prevention & control*; D019990:Perioperative Care / Q000379:methods*; D019095:Point-of-Care Systems