Senior Consultant, Department of Anaesthesiology and Intensive Care Medicine, University Hospital Essen, Germany
Dr. Klaus Görlinger worked as a Senior Consultant for Anaesthesiology, Intensive Care and Emergency Medicine, Pain Therapy, and Haemostaseology at the Department of Anaesthesiology and Intensive Care Medicine, University Hospital Essen, Germany, responsible for trauma surgery and emergency medicine, visceral surgery and liver transplantation, and thoracic and cardiovascular surgery from December 1986 until June 2012. His main field of research is the development and implementation of point-of-care-guided algorithms for goal-directed perioperative bleeding management and patient blood management.
Since 2007, he is an affiliate member of the ASA. From 2009 to 2012 he worked as the chair of the section ‘Clinical Haemotherapy and Haemostasis Management’ of the German Interdisciplinary Association of Critical Care and Emergency Medicine (DIVI) and as a member of the scientific subcommittee ‘Transfusion and Haemostasis’ and the ‘Task Force for Management of Severe Perioperative Bleeding’ of the European Society of Anaesthesiology (ESA). He is one of the authors of the ESA guidelines on the management of severe perioperative bleeding from 2013. Since July 2012 he is the Medical Director of TEM Innovations GmbH, Munich, Germany, which since 2016 belongs to the Instrumentation Laboratory/Werfen Life group.
He published 91 PubMed-listed papers as well as numerous abstracts and book chapters. His ResearchGate score is 39.9 (220 research items, 81,332 reads, 124 recommendations, 5,240 citations) and his h-index 37.
Maternal morbidity and mortality due to PPH is still a global issue. Coagulopathy can be detected in about 25% of patients with severe PPH and is characterized by hyperfibrinolysis and/or fibrinogen deficiency. Here, hyperfibrinolysis most often occur in PPH with severe shock or in patients with amniotic fluid embolism. Based on the WOMAN trial, it is recommended to administer TXA early (within 3 h after labour) in patients with severe PPH. Furthermore, quick changes in fibrin polymerization (FIBTEM) are key issues in the development and progression of severe PPH. Here, Collins et al. showed that FIBTEM A5 is superior to Clauss fibrinogen to predict progression of PPH to a total blood loss of more than 2500 ml. Women with progression of PPH had a median (IQR) FIBTEM A5 of 12 (7-17) mm, compared to 19 (17-23) mm for those not progressing. Accordingly, the FIBTEM A5 cut-off value for our PPH algorithm was set to < 12 mm and the target to ³ 16 mm. This is in line with the Liverpool algorithm published by Mallaiah et al. and the recommendations from the ISTH SSC. McNamara, Mallaiah et al. reported in their study a strong reduction in blood transfusion, large volume blood transfusion (> 5 U RBCs), hysterectomy rate, TACO, and ICU admission in the ROTEM group. Similar results have been published by Snegovskikh et al. (Yale University, US). In contrast, pre-emptive administration of fibrinogen concentrate in severe PPH was not effective and is therefore not recommended in the ISTH guidelines. Also, the OBS2-RCT did not show any benefit in the subgroup administering fibrinogen concentrate if FIBTEM A5 was 13-15 mm. In contrast, patients with a FIBTEM A5 £ 12 mm showed a reduction in blood loss after study drug and in transfusion of allogeneic blood products. Accordingly, Collis claimed in 2016 that viscoelastic POC testing should be mandatory on the labour ward.