Viscoelastic Monitoring to Guide the Correction of Perioperative Coagulopathy and Massive Transfusion in Patients with Life-Threatening Hemorrhage

Anesthesiol Clin. 2019 Mar;37(1):51-66. doi: 10.1016/j.anclin.2018.09.004. Epub 2018 Dec 19.


The resuscitation of patients with traumatic hemorrhage remains a challenging clinical scenario. The appropriate and aggressive support of the patient's coagulation is of critical importance. Conventional coagulation assays present several shortcomings in this setting. The integration of viscoelastic monitoring in clinical practice has the potential to result in significant improvements. In order to be successful, the provider must understand basics of the methodology, read outs, and the limitations of the technique.

Keywords: Acute traumatic coagulopathy (ATC); Hemostasis; Hemostatic resuscitation; Massive transfusion; Thromboelastograhy; Thromboelastometry; Trauma-induced coagulopathy (TIC); Viscoelastic testing.

Publication types

  • Review

MeSH terms

  • Blood Coagulation
  • Blood Coagulation Disorders / etiology
  • Blood Coagulation Disorders / therapy*
  • Blood Transfusion / methods*
  • Hemorrhage / etiology
  • Hemorrhage / therapy*
  • Humans
  • Monitoring, Physiologic / methods*
  • Perioperative Care / methods*
  • Resuscitation / methods
  • Severity of Illness Index
  • Thrombelastography / methods
  • Wounds and Injuries / complications