clinical-needClinical Need

The market for POC coagulation testing is over $1 billion, with applications in major surgery, organ transplantation, trauma and postpartum hemorrhage. Hospitals are actively seeking to reduce their use of blood products and are in need of tools to guide more targeted transfusion practices.

Critical Bleeding and the Risk of Transfusion

Critical bleeding is an issue in major surgeries, organ transplants, trauma and postpartum hemorrhage. In cardiac surgery, post-surgical bleeding occurs in up to 20% of cases. Bleeding can result from the depletion of coagulation factors, platelets or fibrinogen, hyperfibrinolysis, the presence of residual anticoagulants, or some combination of these factors. Each cause has a specific treatment option, the use of which can restore hemostasis. However, the transfusion of blood products increases the risk of infection, morbidity and length of stay. Determining when blood products are needed, which product is appropriate and how much to give is a major challenge for clinicians.

Need for Rapid, Comprehensive, Accurate Information to Guide Treatment

Current hemostatic tests provide only a subset of needed information, or take too long to be useful in critical bleeding situations, forcing clinicians to use iterative transfusion protocols that do not account for the patient’s actual coagulation status. This approach leads to over-transfusion and transfusion of inappropriate products. Up to 60% of red blood cell (RBC) transfusions lack clinical justification. Further, blood products are costly, making up about 1-2% of a hospital’s budget. Hospitals around the world are thus seeking ways to reduce their transfusion rates to improve outcomes and reduce costs.

Guidelines Support Need for POC Testing

The 2011 Update to The Society of Thoracic Surgeons and the Society of Cardiovascular Anesthesiologists Blood Conservation Clinical Practice Guidelines states that transfusion of non red blood cell products should “preferably [be] guided by specific point-of-care tests that assess hemostatic function in a timely and accurate manner.”

See the full list of guidelines calling for point-of-care coagulation analysis.

HemoSonics’ rapid, comprehensive measurement of the treatable components of hemostasis imbalance at the point of care is intended to provide important guidance to clinicians, enabling them to choose the correct treatment option to more quickly restore hemostasis and improve outcomes.


References

Weber CF et al. Point-of-care testing: a prospective, randomized clinical trial of efficacy in coagulopathic cardiac surgery patients. Anesthesiology. 2012 Sep;117(3):531-47.

Seicean et al. The effect of blood transfusion on short-term, perioperative outcomes in elective spine surgery. J Clin Neurosci. 2014;21:1579-85.

Hajjar LA, Vincent JL, Galas FR, et al. Transfusion requirements after cardiac surgery: the TRACS randomized controlled trial. JAMA. 2010; 304:1559–67.

Koch CG et al. Transfusion in coronary artery bypass grafting is associated with reduced long-term survival. Ann Thorac Surg. 2006 May;81(5):1650-7.

Orlov et al. Platelet Dysfunction as Measured by a Point-of-Care Monitor is an Independent Predictor of High Blood Loss in Cardiac Surgery. Anesth Analg 2014;118:257–63.

Shander A, Fink A, Javidroozi M, Erhard J, et al. Appropriateness of allogeneic red blood cell transfusion: the international consensus conference on transfusion outcomes. Transfus Med Rev. 2011 Jul;25(3):232-246.