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...
Viscoelastic Coagulation Testing: Use and Current Limitations in Perioperative Decision-making
This article has been selected for the Anesthesiology CME Program. Learning objectives and disclosure and ordering information can be found in the CME section at the front of this issue.
This article is featured in “This Month in Anesthesiology,” page A1.
Brian T. Bateman, M.D., M.Sc., served as Handling Editor for this article.
Submitted for publication January 8, 2021. Accepted for publication March 26, 2021. Published online first on May 12, 2021.
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Gabor Erdoes, Andreas Koster, Jerrold H. Levy; Viscoelastic Coagulation Testing: Use and Current Limitations in Perioperative Decision-making. Anesthesiology 2021; 135:342–349 doi: https://doi.org/10.1097/ALN.0000000000003814
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