Fig. 4. Proposed algorithm for decision support. Cardiovascular, pulmonary, traumatic as well as hemostatic factors need to be considered. Conventional pain therapy must be optimized before considering epidural analgesia. If available, platelet function analysis should be performed in patients treated with antiplatelet drugs or in case of expected platelet function disorders. It is important to note that epidural catheterization and mechanical ventilation are not necessarily mutually exclusive as endpoints, and the pathways can be interconnected and synergistic. INR = International Normalized Ratio; LMWH = low molecular weight heparin; Multiplate® = MEA = multiple electrode aggregometry; ROTEM® = rotational thromboelastometry; TEG® = thrombelastography; VerifyNow® = whole blood turbidimetric platelet aggregometry.