The Role of Viscoelastic Testing in Assessing Hemostasis: A Challenge to Standard Laboratory Assays?

Abstract

Viscoelastic testing is increasingly being used in clinical and research settings to assess hemostasis. Indeed, there are potential situations in which viscoelastic testing is reportedly superior to standard routine laboratory testing for hemostasis. We report the current testing platforms and terminology, as well as providing a concise narrative review of the published evidence to guide its use in various clinical settings. Notably, there is increasing evidence of the potential utility of viscoelastic testing for assessment of direct oral anticoagulants, and bleeding associated with chronic liver disease, orthotopic liver transplantation, cardiac surgery, trauma, obstetrics and pediatrics.

Keywords: coagulation; hemostasis; transfusion; viscoelastic testing.

Figure 1

Typical VET waveform (source [22]).