Rapid diagnosis and therapy of coagulopathy plays a key role in the care of the severely bleeding patient in major trauma, postpartum hemorrhage, or major surgery. Perioperative diagnostic and treatment algorithms are mostly guided by viscoelastic point-of-care coagulation assays. There is convincing evidence that implementing transfusion algorithms based on the results of viscoelastic point-of-care coagulation tests can reduce transfusions and lead to improved patient outcomes (table 1).1–4  In the perioperative period, two assays are most often used: the kaolin thromboelastography (TEG) and the functional fibrinogen TEG as part of TEG-based viscoelastic monitoring and the tissue factor–activated rotational thromboelastometry (ROTEM, also called “EXTEM”) and fibrinogen ROTEM (also called “FibTEM”) assays as part of ROTEM-based viscoelastic monitoring. These assays are designed to help answer basic questions regarding treatment of perioperative coagulopathy, such as when should the clinician...

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