As our understanding of coagulation and traumatic resuscitation grows, there has been an increased push towards quicker laboratory results on coagulation status and a more goal-directed resuscitation of the trauma patient. But at what cost? Will point-of-care testing bankrupt our already heavily burdened health care systems?
Dr. Michael Ganter is the Director and Chairman of the Institute of Anesthesiology at Kantonsspital Winterthur, Switzerland. He is Swiss Board Certified in Anesthesiology, Critical Care Medicine and Prehospital Emergency Medicine. His interests include quality metrics for anesthesia, trauma, transplantation, critical care, and perioperative monitoring.
Dr. Michael Ganter writes this editorial in response to the economic impact of point-of-care coagulation testing. He gives a quick review of what is currently known about the benefits of goal directed and algorithm driven resuscitation. This is followed by how it has been implemented at his busy level 1 trauma center, Kantonsspital Winterthur. He then gives a break down of how his hospital laboratory is set up, the costs of implementation, and how it compares to traditional testing. For perspective, he also writes about the respective costs of blood products (direct and indirect), coagulation factors, and reminds us of the costs of potential complications. Hopefully you will find this article as interesting as I did.