Viscoelastic testing: an illustrated review of technology and clinical applications

Hartmann, Jan; Hermelin, Daniela; Levy, Jerrold H.

doi:10.1016/j.rpth.2022.100031

Cited by 25 publications

(40 citation statements)

References 76 publications

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“…28 VET, on the other hand, allows for a more dynamic view of hemostasis and includes additional information, such as the durability, strength, and time to initiation of the clot. 15,26 The importance of the cell-based model of hemostasis has been appreciated for over 20 years, 60 but its implementation into clinical practice has been slow to adopt. Risk stratification for thrombotic complications has been validated by Khorana et al utilizing clinical risk factors to accommodate for the different variables that impact hypercoagulability.…”

Section: Discussionmentioning

confidence: 99%

“…28 VET, on the other hand, allows for a more dynamic view of hemostasis and includes additional information, such as the durability, strength, and time to initiation of the clot. 15 26…”

Section: Discussionmentioning

confidence: 99%

“…Finally, decreased CL can be associated with fibrinolysis shutdown. 14,15,[26][27][28] VET is not well documented in the breast cancer setting. Its utility in other cancers has been documented with conflicting results, at times due to small populations, mixed malignancies, the heterogeneity of cancer, or due to different stages of disease.…”

mentioning

confidence: 99%

“…Finally, the LY30 variable in TEG is similar to clot lysis (CL) in ROTEM, representing the percent lysis of the clot in 30 minutes after MA and CT, respectively. 15 26…”

mentioning

confidence: 99%

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Applications of Viscoelastic Testing in Breast Cancer Patients: A Systematic Review Focusing on Hypercoagulability and Free Flap Thrombosis

Pamulapati,

Conroy,

Madireddy

et al. 2023

Semin Thromb Hemost

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Viscoelastic testing is a clinically available method to assess hypercoagulability. This systematic review aims to provide a comprehensive overview of the existing literature and the potential use of such testing in patients with breast cancer. A systematic literature search for studies investigating the application of viscoelastic testing for patients with breast cancer was conducted. Studies were included as long as they were original, peer-reviewed, and in the English language. Studies were excluded if they were review articles, did not include breast cancer patients, or if the full text was unavailable. This review identified 10 articles that met the inclusion criteria. Two of the studies utilized rotational thromboelastometry, and an additional four studies used thromboelastography, to assess hypercoagulability in patients with breast cancer. Three of the identified articles discussed the use of thromboelastometry in free flap breast reconstruction for patients with breast cancer. One study was a retrospective chart review looking at thromboelastography and microsurgical breast reconstruction. Current literature regarding the application of viscoelastic testing in breast cancer and free flap breast reconstruction is limited, with no randomized trials thus far. However, some studies suggest that there may be potential utility in viscoelastic testing to assess risk for thromboembolism in breast cancer patients, and future research in this area is warranted.

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Section: Discussionmentioning

confidence: 99%

“…28 VET, on the other hand, allows for a more dynamic view of hemostasis and includes additional information, such as the durability, strength, and time to initiation of the clot. 15 26…”

Section: Discussionmentioning

confidence: 99%

mentioning

confidence: 99%

“…Finally, the LY30 variable in TEG is similar to clot lysis (CL) in ROTEM, representing the percent lysis of the clot in 30 minutes after MA and CT, respectively. 15 26…”

mentioning

confidence: 99%

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Applications of Viscoelastic Testing in Breast Cancer Patients: A Systematic Review Focusing on Hypercoagulability and Free Flap Thrombosis

Pamulapati,

Conroy,

Madireddy

et al. 2023

Semin Thromb Hemost

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“…VET measures whole blood clotting using several testing modalities whereby the physical attributes identified in the test are converted into a computer‐generated tracing. VET offers several advantages over traditional coagulation tests, including a more holistic picture of coagulation in real‐time, point of care fashion 4 . Clot initiation, amplification, propagation, strength, and dissolution are measured and displayed both graphically and numerically and provide individualized patient data on whole blood hemostatic properties 5,6 …”

Section: Interpretation Of Vet Tracingsmentioning

confidence: 99%

The clot thickens: How to use viscoelastic testing in critical illness

Rech

Gilbert

Nei

et al. 2023

J Am Coll Clin Pharm

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Coagulopathy is common in critically ill patients and may result in complications such as bleeding or thromboembolic events. Viscoelastic testing (VET), including both thromboelastography (TEG®) and rotational thromboelastometry (ROTEM®), offers a benefit over conventional coagulation tests in that it provides a qualitative and quantitative assessment of the degree of coagulopathy, including the ability to measure fibrinolysis. This review is a “how‐to” primer for critical care pharmacists to interpret and utilize VET in practice across a spectrum of coagulopathies, including trauma and traumatic brain injury, neurologic injury and emergencies, cardiothoracic surgery, liver disease, and medication‐induced coagulopathy.

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