Related Experiment Video
Updated: Jun 6, 2025
06:28
Leveraging Turbidity and Thromboelastography for Complementary Clot Characterization
Published on: June 4, 2020
6.7K
Thromboelastography or rotational thromboelastometry guided algorithms in bleeding patients: An updated systematic
A D Kvisselgaard1, S A Wolthers2, A Wikkelsø3
1Department of Anesthesia and Intensive Care, Copenhagen University Hospital-Herlev, Copenhagen, Denmark.
Acta Anaesthesiologica Scandinavica
|December 3, 2024
Summary
Thromboelastography (TEG) or rotational thromboelastometry (ROTEM) guided transfusion may reduce blood product use and reintervention in bleeding patients. However, the evidence is very uncertain, particularly for mortality benefits.
Area of Science:
- Critical Care Medicine
- Transfusion Medicine
- Evidence-Based Medicine
Background:
- Bleeding patients face high morbidity and mortality due to impaired hemostasis.
- Optimal hemostatic resuscitation strategies remain unclear.
- This review assesses TEG/ROTEM-guided transfusion versus standard care in bleeding patients.
Approach:
- Systematic review and meta-analysis of 31 randomized controlled trials (RCTs) including pediatric and adult patients.
- Conducted according to Cochrane, PRISMA, and GRADE guidelines.
- Primary outcome: mortality; Secondary outcomes: blood product administration, blood loss, reintervention, renal injury.
Key Points:
- TEG/ROTEM guidance reduced fresh frozen plasma (FFP) and platelet transfusion, surgical reintervention, and bleeding volume.
- No statistically significant difference in mortality was observed.
- Evidence certainty for all outcomes was rated as very low by GRADE.
Conclusions:
- TEG/ROTEM-guided transfusion may decrease mortality risk, bleeding, and need for FFP and platelets, but evidence is very uncertain.
- Findings were predominantly based on adult cardiac surgery patients.
- Further research is needed to confirm these potential benefits.
