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Review
. 2022 Jan-Mar;25(1):1-10.
doi: 10.4103/aca.aca_319_20.

Clinical application of viscoelastic point-of-care tests of coagulation-shifting paradigms

Soumya Sankar Nath  1 , Chandra Kant Pandey  2 , Sumit Kumar  1
Affiliations
Review

Clinical application of viscoelastic point-of-care tests of coagulation-shifting paradigms

Soumya Sankar Nath et al. Ann Card Anaesth. 2022 Jan-Mar.

Abstract

Bleeding during cardiac surgery, liver transplant, trauma and post partum hemorrhage are often multifactorial and these factors are dynamic as new factors crop up during the course of management. Conventional tests of coagulation offer information of a part of the coagulation system and also is time consuming. Viscoelastic point of care tests (VE POCTs) like rotational thromboelastometry, thromboelastogram and Sonoclot, are based on analysis of the viscoelastic properties of clotting blood and provide information for the entire coagulation pathway. In this comprehensive review being presented here, we have examined the pros and cons of VE POCTs including clinical, cost and survival benefits. The recommendations of the various guidelines regarding use of VE POCTs in various scenarios have been discussed. The review also tried to offer suggestions as to their optimal role in management of bleeding during cardiac surgeries, extracorporeal membrane oxygenation, left ventricular assist devices, liver transplant and briefly in trauma and postpartum hemorrhage.

Keywords: Cardiac surgery; liver transplant; point of care tests; postpartum hemorrhage; rotational elastometry; sonoclot; thromboelastograph; trauma; viscoelastic.

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Conflict of interest statement

None

Figures

Figure 1
Figure 1
Schematic diagram of TEG® and ROTEM® curves with their corresponding parameters.
See this image and copyright information in PMC

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