POCT in Cardiovascular Operating Room: A Game Changer?

Point of care testing (POCT) refers to diagnostic tests performed near the patient, rather than in a laboratory, It has been an essential component of operating rooms (ORs) since it was first introduced in the 1980s as it offers rapid diagnostic results that help physicians and surgeons to take critical care decisions, affecting the treatment pathway of a patient. This is particularly crucial in cardiovascular surgeries, where swift and accurate assessments of coagulation status, blood gases and other critical parameters are vital for patient safety and improved patient outcomes [1,2]. The main selling point of POCTs are their ability to deliver immediate and accurate results, enabling surgeons to make prompt, informed decisions in tense situations during surgery [1,3]. Traditional central laboratories often involve huge delays due to sample transportation and processing times, which can be fatal in the fast paced OR environment. POCT devices that are located near the OR eliminate these delays, allowing for real time monitoring of the patient’s physiological status. For instance, during cardiopulmonary bypass (CPB) procedures, maintaining appropriate anticoagulation is critical to prevent thrombosis and hemorrhage. ACT, ROTEM, Sonoclot, Clotpro,i-STAT,PFA-100 etc are commonly used to asses hypercoagulability and hypocoagulability[4]. Implementing these technologies has been shown to improve precision and reduce the time required for repeat testing, thereby enhancing overall efficiency in the Cardiovascular Operating room [5,6]. ACT is essential for monitoring heparin anticoagulation during CPB. POCT devices help to provide rapid ACT results, facilitating timely adjustments to heparin dosing [5,7] The function of all POCT devices are listed in the table below.