Precision hemostasis: how viscoelastic testing guides real-time decision-making in trauma

Area of Science:

• Hematology
• Trauma Surgery
• Diagnostic Technologies

Background:

• Viscoelastic testing is a well-established yet advancing technology in trauma care.
• Conventional coagulation tests offer limited, specific insights into hemostasis.
• Viscoelastic methods provide a comprehensive, global perspective on blood clot formation and dynamics.

Purpose of the Study:

• To review the historical development of viscoelastic testing.
• To detail the technical principles of rotational thromboelastometry (ROTEM) and thromboelastography (TEG).
• To summarize current clinical data regarding the use of ROTEM and TEG in managing traumatic injuries.

Main Methods:

• Literature review of historical and current research on viscoelastic testing.
• Analysis of technical specifications for ROTEM and TEG devices.
• Synthesis of clinical studies evaluating ROTEM and TEG in trauma patient management.

Main Results:

• Viscoelastic testing provides a holistic view of the coagulation cascade, unlike segmented conventional assays.
• ROTEM and TEG are the primary modalities currently employed for viscoelastic assessment.
• Clinical data supports the utility of these tests in guiding transfusion strategies and monitoring hemostasis in trauma.

Conclusions:

• Viscoelastic testing, encompassing ROTEM and TEG, is crucial for comprehensive coagulation assessment in trauma.
• Understanding the technical aspects and clinical applications of these tests is vital for effective patient management.
• Continued research and integration of viscoelastic testing enhance the care of trauma patients with bleeding disorders.