Intevnsive Care Unit, Liverpool Hospital, South Western Sydney Local Health District, Liverpool, New South Wales, Australia.
South Western Sydney Clinical School, University of New South Wales, Sydney, New South Wales, Australia.
Acta Anaesthesiol Scand. 2025 Jan;69(1):e14533. doi: 10.1111/aas.14533.
Viscoelastic testing (VET) has been implemented in clinical care to diagnose and manage coagulation in patients with manifest or high risk of major bleeding. However, the breakdown of formed blood clots, that is, fibrinolysis, has been comparatively less studied. There is an increasing recognition that acute infections trigger a dysregulated immunothrombotic response, which has focused attention on viscoelastic testing to identify in particular fibrinolysis resistant states.
This scoping review on fibrinolysis assessment using viscoelastic testing will be conducted according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses extension for Scoping Reviews (PRISMA-ScR). Publications will be included in the review if they evaluate the fibrinolytic capacity of adult patients admitted to an intensive care unit (ICU) for acute infection (including SARS-CoV2) using VET assays that included a fibrinolytic agent. No date or language restrictions will be applied, and all study designs will be considered. A peer-reviewed search strategy will be employed in multiple electronic bibliographic databases and will also include the grey literature.
The included studies will be reported by descriptive analyses and tabulated results.
This scoping review aims to map the research describing viscoelastic testing (VET) to assess fibrinolysis in acutely infected critically ill patients, with the goal of identifying diagnostic capabilities, any associations with patient outcomes, and the potential to guide clinical management.
黏弹性测试（VET）已在临床护理中实施，以诊断和管理有明显或大出血高风险的患者的凝血功能。然而，形成的血凝块（即纤维蛋白溶解）的破裂相对研究较少。越来越多的人认识到急性感染会引发失调的免疫血栓反应，这使得人们关注黏弹性测试，以确定特别是纤维蛋白溶解抵抗状态。
本研究将根据系统评价和荟萃分析扩展的首选报告项目（PRISMA-ScR），对使用黏弹性测试评估纤维蛋白溶解的研究进行综述。如果使用包含纤维蛋白溶解剂的 VET 检测评估急性感染（包括 SARS-CoV2）入住重症监护病房（ICU）的成年患者的纤维蛋白溶解能力，将纳入研究。将不限制日期或语言，并且将考虑所有研究设计。将采用同行评议的搜索策略在多个电子书目数据库中进行，并将包括灰色文献。
将通过描述性分析和表格结果报告纳入的研究。
本研究旨在描述使用黏弹性测试（VET）评估急性感染危重症患者纤维蛋白溶解的研究，目的是确定诊断能力、与患者结局的任何关联以及指导临床管理的潜力。
