Thromboelastography or thromboelastometry to guide haemostatic treatment versus usual care
Kvisselgaard AD, Wolthers SA, Wikkelsø AJ, et al., 2026 · 35 studies included
Summary
Thirty-five trials included 3096 participants, predominantly adults undergoing elective cardiac surgery. Apparent benefits in mortality and selected blood-product outcomes were very uncertain.
Conclusion
Very-low-certainty evidence does not establish universal ICU, trauma or obstetric benefit; use indication-specific evidence and validated local algorithms.
Clinical Context & Relevant Topics (4)
Disease ReferenceRead whole-blood clot initiation, propagation, firmness and lysis without treating device-specific values as universal transfusion orders.
The trauma lethal diamond (hypothermia, acidosis, coagulopathy, hypocalcemia), 1:1:1 massive transfusion (PROPPR trial), early TXA (CRASH-2), and TEG/ROTEM algorithms.
Patient-specific RBC transfusion thresholds, current platelet/procedural thresholds, plasma/cryoprecipitate use, and the TRALI vs TACO diagnostic matrix.
ICU priorities after major multisystem trauma: hemorrhage control, damage-control resuscitation, TBI-aware perfusion, coagulopathy correction, compartment syndromes and staged definitive care.