Department of Pathology, Feinberg School of Medicine, Northwestern University, Chicago, Illinois.
Semin Thromb Hemost. 2022 Oct;48(7):785-795. doi: 10.1055/s-0042-1756192. Epub 2022 Sep 29.
An important aim of viscoelastic testing (VET) is to implement transfusion algorithms based on coagulation test results to help reduce transfusion rates and improve patient outcomes. Establishing a rapid diagnosis and providing timely treatment of coagulopathy is the cornerstone of management of severely bleeding patients in trauma, postpartum hemorrhage, and major surgery. As the nature of acute bleeding and trauma leads to an unstable and tenuous physiologic state, conventional coagulation tests (CCTs) are too slow to diagnose, manage, and also course correct any hemostatic abnormalities that accompany an acute critical illness. Viscoelastic point-of-care tests strongly correlate with results from standard laboratory tests but are designed to enable clinicians to make timely, informed bleeding management decisions when time to intervene is critical. These assays provide an individualized and goal-oriented approach to patient blood management and are increasingly becoming involved in transfusion algorithms. The scope of this review aims to evaluate the current literature on VETs and their impact on actionable outputs in clinical decision making and their relationship to CCT.
黏弹性检测（VET）的一个重要目标是基于凝血检测结果实施输血算法，以帮助降低输血率并改善患者的预后。在创伤、产后出血和大手术中，快速诊断和及时治疗凝血功能障碍是严重出血患者管理的基石。由于急性出血和创伤的性质导致生理状态不稳定和脆弱，常规凝血检测（CCT）太慢，无法诊断、管理和纠正伴随急性危重病的任何止血异常。即时黏弹性检测与标准实验室检测结果具有很强的相关性，但旨在使临床医生在需要干预时能够及时做出明智的出血管理决策。这些检测方法为患者的血液管理提供了个体化和目标导向的方法，并越来越多地应用于输血算法中。本综述的目的在于评估目前关于 VET 及其对临床决策中可操作输出的影响的文献，并评估它们与 CCT 的关系。
