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Review
. 2023 Oct;45(5):643-658.
doi: 10.1111/ijlh.14144. Epub 2023 Aug 9.

Viscoelastic testing: Critical appraisal of new methodologies and current literature

Geoffrey D Wool  1 , Timothy Carll  1
Affiliations
Review

Viscoelastic testing: Critical appraisal of new methodologies and current literature

Geoffrey D Wool et al. Int J Lab Hematol. 2023 Oct.

Abstract

United States Food and Drug Administration (FDA)-approved viscoelastic testing (VET) methodologies have significantly changed in the last 10 years, with the availability of cartridge-based VET. Some of these cartridge-based methodologies use harmonic resonance-based clot detection. While VET has always allowed for the evaluation of real-time clot formation, cartridge-based VET provides increased ease of use as well as greater portability and robustness of results in out-of-laboratory environments. Here we review the use of VET in a variety of clinical contexts, including cardiac surgery, trauma, liver transplant, obstetrics, and hypercoagulable states such as COVID-19. As of now, high quality randomized trial evidence for new generation VET (TEG 6s, HemoSonics Quantra, ROTEM sigma) is limited. Nevertheless, the use of VET-guided transfusion algorithms appears to result in reduced blood usage without worsening of patient outcomes. Future work comparing the new generation VET instruments and continuing to validate clinically important cut-offs will help move the field of point-of-care coagulation monitoring forward and increase the quality of transfusion management in bleeding patients.

Keywords: blood transfusion; fibrinogen; fibrinolysis; hemostasis; laboratory practice; platelets.

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References

REFERENCES

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