Gorlinger Klaus, Bhardwaj Vandana, Kapoor Poonam Malhotra
Department of Anesthesiology and Intensive Care Medicine, University Hospital Essen, Essen, Germany.
Department of Cardiac Anaesthesiology, Cardio Thoracic Centre, All India Institute of Medical Sciences, New Delhi, India.
Ann Card Anaesth. 2016 Jul-Sep;19(3):516-20. doi: 10.4103/0971-9784.185546.
Computer simulations can come in handy to train medical personnel with necessary skills to face the clinical scenarios involving various coagulopathies. Now a days, point of care (POC) devices such as thromboelastography, Sonoclot analyzer and newly approved rotational thromboelastometry (ROTEM) with faster results to assess coagulopathies are available on bedside of patients. ROTEM is emerging as a quick, portable, and well-validated device to evaluate coagulopathy in critical care and perioperative setup. A novel platelet-aggregometry integrated module enables simultaneous analysis of platelets as well as coagulation tests on the same screen. The entire gamut of POC signature curves obtained with different coagulation defects can be learned with graphical simulations. These simulations can be a valuable strategy to elucidate latent conditions, for which simulation interventions can then be designed to mimic different clinical scenarios.
计算机模拟有助于培训医务人员掌握应对各种凝血病临床场景所需的技能。如今，诸如血栓弹力图、Sonoclot分析仪以及新获批的旋转血栓弹力测定法（ROTEM）等即时检测（POC）设备可在患者床边使用，其评估凝血病的结果更快。ROTEM正在成为一种快速、便携且经过充分验证的设备，用于在重症监护和围手术期评估凝血病。一个新型血小板聚集测定集成模块能够在同一屏幕上同时分析血小板和凝血检测。通过图形模拟可以了解不同凝血缺陷所获得的POC特征曲线的全貌。这些模拟可以成为阐明潜在状况的宝贵策略，进而可以设计模拟干预措施来模拟不同的临床场景。
