Systematic evaluation of evidence on veterinary viscoelastic testing part 1: System comparability

Area of Science:

• Veterinary Medicine
• Point-of-Care Diagnostics
• Hemostasis Monitoring

Background:

• Thromboelastography (TEG) and rotational thromboelastometry (ROTEM) are viscoelastic point-of-care instruments used for hemostasis monitoring.
• Assessing the comparability of results between these two systems is crucial for accurate clinical decision-making.

Purpose of the Study:

• To systematically review the existing evidence regarding the comparability of TEG and ROTEM systems.
• To identify any knowledge gaps concerning the interchangeability of data generated by these analyzers.

Main Methods:

• A systematic literature evaluation was conducted using databases such as Medline, PubMed, CAB abstracts, and Google Scholar.
• Relevant articles were categorized by their level of evidence and quality.
• Consensus was developed for applying findings to clinical practice.

Main Results:

• Eight relevant articles were identified and analyzed.
• None of the studies supported the direct comparability of the two systems.
• One study was neutral (Level of Evidence 6, Poor quality), and seven studies opposed comparability (varying levels of evidence and quality).

Conclusions:

• Results generated by TEG and ROTEM analyzers are not directly comparable.
• Extrapolation of results between these machines should be avoided.
• Standardization of preanalytical variables (e.g., blood collection, holding time, temperature) is strongly recommended.
• Each institution should establish site-specific reference values for each machine.