Clinical Need
Hospitals are actively seeking to reduce their use of blood products and are tasked to improve transfusion practices*.
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 2013 Practice Guidelines for Perioperative Blood Management Issued by the American Association for Anesthesiology Task Force indicated “If coagulopathy is suspected, obtain viscoelastic assays …, when available, as well as platelet count”. Further, the 2016 Update to the European Society of Anaesthesiology Guidelines on the Management of severe perioperative bleeding recommended “the application of intervention algorithms incorporating pre-defined triggers and targets based on viscoelastic haemostatic (VHA) coagulation monitoring to guide individualised haemostatic intervention in the case of perioperative bleeding”.
Guidelines calling for POC viscoelastic testing published by major medical societies:
- European Society of Anesthesiology
- American Society of Anesthesiologists
- Society of Cardiovascular Anesthesia
- Society of Thoracic Surgeons
*The Quantra QPlus System has not been evaluated to guide blood product use or use of medication.
References
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