Abstract
During cardiac surgery, there are major disturbances in coagulation systems caused by perioperative hemodilutional changes. Conversely, procoagulant activity and inflammation are increased postoperatively because of physiological stress responses. Thus, perioperative monitoring of coagulation markers may be required for differential diagnosis of hemorrhage and to decrease perioperative thrombotic complications. Dilutional coagulopathy which is followed by hemorrhage is often refractory at the end of cardiopulmonary bypass. Understanding the limitations of coagulation tests with plasma samples in central laboratory is important for applying these tests to perioperative hemostatic management. Recently, Point-of-care devices (e.g. prothrombin times, fibrinogen concentrations, rotational thromboelastometry, etc.) are increasingly being used in clinical practice, especially in patients undergoing cardiac surgery. The combination of several hemostatic/coagulation tests is the key to establish optimal hemostatic strategies in cardiac surgery.
