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Viscoelastometric Point-of-Care Testing for Vascular Surgery and Obstetrics: A Review of Clinical Utility and Guidelines

Last updated: January 4, 2016
Project Number: RC0733-000
Product Line: Rapid Response
Research Type: Devices and Systems
Report Type: Summary with Critical Appraisal
Result type: Report

Question

  1. What is the clinical utility of viscoelastometric point-of-care testing (POCT) for vascular surgery patients?
  2. What is the clinical utility of viscoelastometric POCT for obstetrical hemorrhage patients?
  3. What are the evidence-based guidelines regarding the use of viscoelastometric POCT in vascular surgery patients?
  4. What are the evidence-based guidelines regarding the use of viscoelastometric POCT in obstetrical hemorrhage patients?

Key Message

Significant reductions were reported in the transfusion of some allogeneic blood products, with patients undergoing aortic surgery under the rotational thromboelastometry (ROTEM)- or thromboelastography (TEG)-guided protocol, compared to patients under standard care. Significant reductions were also reported in the administration of some coagulation factors, with patients undergoing aortic surgery under the ROTEM-guided protocol, compared to patients under standard care. No significant differences between the ROTEM and standard care groups were reported in the need for massive transfusion or re-exploration for bleeding or blood losses in the first 12 and 24 post-operative hours. Aside from significant reductions in composite bleeding and thrombotic or thromboembolic adverse events with the ROTEM group, compared to the standard care group, no other significant differences between the two groups were reported in other clinical outcomes and adverse events, such as complications, length of hospital stay, and in-hospital and six-month mortality.