Background and Goal of Study: 
A previous retrospective study showed that point of care (POC) coagulation tests reduce the requirements for hemostatic products and shorten hospital stay.1 However, few prospective studies have provided evidence that POC coagulation tests have this effect in patients undergoing cardiac surgery.2  The current investigation aimed to use logistic regression analysis to assess the efficacy of hemostatic therapy guided either by conventional coagulation analyses or POC, such as ROTEM™and Hepcon HMS™. 
Material and methods:	
Patients scheduled for cardiac surgery with cardiopulmonary bypass (CPB) were randomized to a conventional or POC group. The criteria for conventional coagulation analyses were as follows: hemoglobin (Hb) >9–10 mg/dL, fibrinogen (Fib) > 100–150 mg/dL, platelet count (Plt) > 5–10×104 /μL. A heparin dose of 300–400 U/kg was administered during CPB, the target activated clotting time (ACT) being >480 sec, and reversed with protamine 100%–130% dose of heparin. ROTEM™ and HMS™ were performed in the POC group. Hemostatic therapy comprised concentrated red cells (CRCs), fresh frozen plasma (FFP), and concentrated platelets (PC). Samples were collected at four points: after induction of anesthesia (baseline), just after commencing CPB, during weaning from CPB, and at the end of surgery. The primary outcome variables were the number of transfused units and blood loss during operation and the first 48 h after ICU. Secondary outcomes were results of multiple logistic regression analysis (stepwise method) in which the dependent variable was with or without allogeneic blood transfusion and independent variables included groups, Hb, Fib, Plt, antithrombin, and age. 
Results and Discussion: 
Fifty-two patients were enrolled in the study. There were no significant differences in blood transfusion and perioperative bleeding between the groups. The secondary outcomes shown in Table 2 were that only Hb, Plt, and age differed significantly between the groups. 
Conclusion: 
Hemostatic therapy based on POC does not reduce patient requirements for allogenic blood products during and after cardiac surgery. 
References:
1. Masui. 2015 Feb;64(2):131-8.
2. Anesthesiology. 2011 Dec;115(6):1179-912.

Point of care coagulation tests do not reduce requirements for allogeneic blood transfusions during and after cardiac surgery