Clinical Practice, Research, and Collaboration with Industry: Impact of the Discontinuation of a Critical Device

Editor—In order to meet the current challenges in anaesthesiology, intensive care, and emergency medicine, highly specialised technologies are increasingly and urgently required. Recent years have seen major innovations, especially in the fields of bleeding diagnostics and individualised coagulation management. In the last 20 yr, point-of-care viscoelastic testing (VET) has become an integral part of goal-directed haemostatic therapy for bleeding patients in trauma, cardiac surgery, transplantation, and postpartum haemorrhage. 1 Gonzalez E. Moore E.E. Moore H.B. et al. Goal-directed hemostatic resuscitation of trauma-induced coagulopathy: a pragmatic randomized clinical trial comparing a viscoelastic assay to conventional coagulation assays. Ann Surg. 2016; 263: 1051-1059 Google Scholar , 2 Agarwal S. Abdelmotieleb M. Viscoelastic testing in cardiac surgery. Transfusion. 2020; 60: S52-S60 Google Scholar , 3 Khanna P. Sinha C. Singh A.K. Kumar A. Sarkar S. The role of point of care thromboelastography (TEG) and thromboelastometry (ROTEM) in management of Primary postpartum haemorrhage: a meta-analysis and systematic review. Saudi J Anaesth. 2023; 17: 23-32 Google Scholar , 4 Park S.Y. Viscoelastic coagulation test for liver transplantation. Anesth Pain Med (Seoul). 2020; 15: 143-151 Google Scholar Viscoelastic testing has gradually replaced standard coagulation tests such as prothrombin time and activated partial thromboplastin time in identifying and monitoring coagulopathy. 5 Weber C.F. Görlinger K. Meininger D. et al. Point-of-care testing: a prospective, randomized clinical trial of efficacy in coagulopathic cardiac surgery patients. Anesthesiology. 2012; 117: 531-547 Google Scholar Moreover, VET-guided haemostatic therapy has been shown to reduce allogeneic blood product transfusion, and in certain indications mortality. 1 Gonzalez E. Moore E.E. Moore H.B. et al. Goal-directed hemostatic resuscitation of trauma-induced coagulopathy: a pragmatic randomized clinical trial comparing a viscoelastic assay to conventional coagulation assays. Ann Surg. 2016; 263: 1051-1059 Google Scholar ,5 Weber C.F. Görlinger K. Meininger D. et al. Point-of-care testing: a prospective, randomized clinical trial of efficacy in coagulopathic cardiac surgery patients. Anesthesiology. 2012; 117: 531-547 Google Scholar Such data have given rise to the development of haemostatic treatment algorithms for bleeding patients, which have subsequently found their way into guidelines and recommendations issued by various societies. 6 Kietaibl S. Ahmed A. Afshari A. et al. Management of severe peri-operative bleeding: guidelines from the European society of anaesthesiology and intensive care: second update 2022. Eur J Anaesthesiol. 2023; 40: 226-304 Google Scholar ,7 Rossaint R. Afshari A. Bouillon B. et al. The European guideline on management of major bleeding and coagulopathy following trauma: sixth edition. Crit Care. 2023; 27: 80 Google Scholar