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Viscoelastic testing: an illustrated review of technology and clinical applications

Viscoelastic testing (VET), including thromboelastography and thromboelastometry, provides a rapid and comprehensive picture of whole blood coagulation dynamics and hemostasis that can be reviewed and evaluated at the point-of-care. This technology is over 50 years old; however, over the past few ye...

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Autores principales: Hartmann, Jan, Hermelin, Daniela, Levy, Jerrold H.
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Elsevier 2022
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9903681/
https://www.ncbi.nlm.nih.gov/pubmed/36760779
http://dx.doi.org/10.1016/j.rpth.2022.100031
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author Hartmann, Jan
Hermelin, Daniela
Levy, Jerrold H.
author_facet Hartmann, Jan
Hermelin, Daniela
Levy, Jerrold H.
author_sort Hartmann, Jan
collection PubMed
description Viscoelastic testing (VET), including thromboelastography and thromboelastometry, provides a rapid and comprehensive picture of whole blood coagulation dynamics and hemostasis that can be reviewed and evaluated at the point-of-care. This technology is over 50 years old; however, over the past few years, there has been a significant increase in research examining the use of VET. Best practice guidelines for the use of VET exist in both the United States and Europe, particularly for elective cardiac surgery, although recommendations for implementation are somewhat limited in some clinical areas by the lack of studies constituting high-grade evidence. Other challenges to implementation surround validation of the technology in some care settings as well as lack of training. Nevertheless, there is a wide range of potential clinical applications, such as treating coagulopathies in liver disease and transplant surgery, critical care, as well as within obstetrical hemorrhage. In this illustrated review, we provide an overview of viscoelastic testing technology (also called viscoelastic hemostatic assays) and describe how the assays can be used to provide a broad overview of hemostasis from clot formation to clot lysis, while highlighting the contribution of coagulation factors and platelets. We then summarize the major clinical applications for viscoelastic testing, including more recent applications, such as in COVID-19. Each section describes the clinical context, and key publications, followed by a representative algorithm and key guidelines
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spelling pubmed-99036812023-02-08 Viscoelastic testing: an illustrated review of technology and clinical applications Hartmann, Jan Hermelin, Daniela Levy, Jerrold H. Res Pract Thromb Haemost Illustrated Review Viscoelastic testing (VET), including thromboelastography and thromboelastometry, provides a rapid and comprehensive picture of whole blood coagulation dynamics and hemostasis that can be reviewed and evaluated at the point-of-care. This technology is over 50 years old; however, over the past few years, there has been a significant increase in research examining the use of VET. Best practice guidelines for the use of VET exist in both the United States and Europe, particularly for elective cardiac surgery, although recommendations for implementation are somewhat limited in some clinical areas by the lack of studies constituting high-grade evidence. Other challenges to implementation surround validation of the technology in some care settings as well as lack of training. Nevertheless, there is a wide range of potential clinical applications, such as treating coagulopathies in liver disease and transplant surgery, critical care, as well as within obstetrical hemorrhage. In this illustrated review, we provide an overview of viscoelastic testing technology (also called viscoelastic hemostatic assays) and describe how the assays can be used to provide a broad overview of hemostasis from clot formation to clot lysis, while highlighting the contribution of coagulation factors and platelets. We then summarize the major clinical applications for viscoelastic testing, including more recent applications, such as in COVID-19. Each section describes the clinical context, and key publications, followed by a representative algorithm and key guidelines Elsevier 2022-12-27 /pmc/articles/PMC9903681/ /pubmed/36760779 http://dx.doi.org/10.1016/j.rpth.2022.100031 Text en © 2022 The Authors https://creativecommons.org/licenses/by/4.0/This is an open access article under the CC BY license (http://creativecommons.org/licenses/by/4.0/).
spellingShingle Illustrated Review
Hartmann, Jan
Hermelin, Daniela
Levy, Jerrold H.
Viscoelastic testing: an illustrated review of technology and clinical applications
title Viscoelastic testing: an illustrated review of technology and clinical applications
title_full Viscoelastic testing: an illustrated review of technology and clinical applications
title_fullStr Viscoelastic testing: an illustrated review of technology and clinical applications
title_full_unstemmed Viscoelastic testing: an illustrated review of technology and clinical applications
title_short Viscoelastic testing: an illustrated review of technology and clinical applications
title_sort viscoelastic testing: an illustrated review of technology and clinical applications
topic Illustrated Review
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9903681/
https://www.ncbi.nlm.nih.gov/pubmed/36760779
http://dx.doi.org/10.1016/j.rpth.2022.100031
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