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Review
. 2020 Mar;46(2):134-146.
doi: 10.1055/s-0040-1702171. Epub 2020 Mar 11.

Diagnosis and Treatment of Trauma-Induced Coagulopathy by Viscoelastography

Jan Hartmann  1 , Mark Walsh  2   3   4 , Anne Grisoli  5 , Anthony V Thomas  2   3 , Faisal Shariff  5 , Ross McCauley  5 , Stefani Vande Lune  5 , Nuha Zackariya  2   3 , Shivani Patel  2   3 , Michael S Farrell  6 , Sherry Sixta  6 , Robert March  2 , Edward Evans  2 , Rebecca Tracy  7 , Elena Campello  8 , Ecaterina Scărlătescu  9 , Vanessa Agostini  10 , João Dias  11 , Sarah Greve  1 , Scott Thomas  3   4
Affiliations
Review

Diagnosis and Treatment of Trauma-Induced Coagulopathy by Viscoelastography

Jan Hartmann et al. Semin Thromb Hemost. 2020 Mar.

Abstract

This article explores the application of viscoelastic tests (VETs) in trauma-induced coagulopathy and trauma resuscitation. We describe the advantages of VETs over conventional coagulation tests in the trauma setting and refer to previous disciplines in which VET use has reduced blood product utilization, guided prohemostatic agents, and improved clinical outcomes such as the mortality of critically bleeding patients. We describe different VETs and provide guidance for blood component therapy and prohemostatic therapy based on specific VET parameters. Because the two most commonly used VET systems, rotational thromboelastometry and thromboelastography, use different activators and have different terminologies, this practical narrative review will directly compare and contrast these two VETs to help the clinician easily interpret either and use the interpretation to determine hemostatic integrity in the bleeding trauma patient. Finally, we anticipate the future of new viscoelastic technologies that can be used in this setting.

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Conflict of interest statement

J.H. and S.G. are employees of Haemonetics Corp., the manufacturer of TEG Hemostasis Analyzers. M.W. and S.T. have received research grants from Haemonetics Corp., Braintree, MA. M.W. is on the speakers' bureau for Portola Inc., San Francisco, CA. E.S. reports grants from the International Society on Thrombosis and Haemostasis and personal fees from Danube University of Krems, Austria; CSL Behring; Weill-Cornell Medicine-Qatar; EurAsia Heart Foundation; and University Hospital Zürich Foundation, outside the submitted work. V.A. reports grants from CSL Behring, Werfen and Ablynx, outside the submitted work. J.D. reports that he is an employee of Haemonetics S.A. Signy, Switzerland. The other authors have nothing to disclose.

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