Monitoring of hemostatic disturbances in cardio-pulmonary bypass patients : pitfalls and prospective solutions

During a cardiac surgical procedure in which a heart-lung machine is used, heparin is administered in high doses. Heparin is a drug that prevents the formation of blood clots. A common side effect being an increased risk of bleeding, the effect of this drug should be monitored carefully. However, currently used routine methods are not sufficient to reflect the coagulation capacity of individual patients. The new methods called calibrated automated thrombography (CAT) and rotational thromboelastometry (ROTEM) are better able to monitor the coagulation status before, during and after cardiac surgery. Furthermore, they can better predict postoperative blood loss. The CAT method in particular seems very promising and can therefore be used as a standard screening test in the future.