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Whole blood thromboelastometry: another Knight at the Roundtable?

Martin H Bluth, Jeffry L Kashuk

Critical Care (London, England)

|January 10, 2012

Summary

Viscoelastic testing like thromboelastography offers real-time insights into trauma-induced coagulopathy, guiding blood product use. However, its role versus conventional tests remains debated due to various factors.

Area of Science:

Coagulation science
Diagnostic methodologies
Transfusion medicine

Background:

Viscoelastic testing, including thromboelastography and thromboelastometry, is increasingly used for assessing coagulation in trauma.
These methods provide real-time functional coagulation profiles, aiding in blood product management for trauma-induced coagulopathy.

Discussion:

The clinical utility of viscoelastic testing in trauma-induced coagulopathy is debated.
Controversies stem from differences in methodology, instrumentation, accessibility, and operator variability.
Its impact on patient care, blood product use, and cost compared to conventional testing requires further evaluation.

Key Insights:

Viscoelastic tests offer dynamic assessment of coagulation function in trauma patients.

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Acceptance is growing among trauma surgeons, anesthesiologists, and transfusion specialists.

Standardization and comparative effectiveness research are crucial for wider adoption.

Outlook:

Further research is needed to clarify the optimal role of viscoelastic testing in trauma care.
Standardizing protocols and addressing accessibility issues will enhance its application.
Evidence-based guidelines are essential for integrating these advanced diagnostics into routine practice.