Les tests de diagnostic rapides d'hémostase lors d'une hémorragie

A repeated and very fast monitoring in real time of the process of coagulation is very important in some circumstances near the patient by point-of-care testing (POCT) in order to diagnose a coagulopathy at an early stage and to guide blood product replacement. These POCT in haemostasis, carried out on whole blood, are especially the activated clotting time in cardiac surgery, in cardiopulmonary bypass or cardiac catheterization, in order to prevent bleeding due to an excess of heparin, thromboelastometry in cardiac surgery, in orthotopic liver transplantation and in severe bleeding in trauma and post-partum. Finally for a long time in many countries in Europe POCT coagulometers are used for the determination of the International Normalized Ratio (INR) for patients under vitamin K antagonists (VKA), in France only for children under VKA, and sometimes in emergency units. These POCT are in France under the responsibility of the laboratory which must ascertain the justification of clinical need and which must conform to the recommendations for the accreditation of the laboratories according to the French norm EN ISO 22870.