Utility of viscoelastic hemostatic assay to guide hemostatic resuscitation in trauma patients: a systematic review.

"fig 2 flow diagram of study selection table 1 characteristics of included studies study study design setting included criteria vha device vha/total sample size transfusion algorithm vha versus control group baksaas-aasen [ ] multi-center randomized controlled trial seven major trauma centers in europe adult trauma patients presented with clinical signs of bleeding activating the local mhp and if rbcs transfusion had been initiated teg 6s or rotem 201/396 teg or rotem versus cct cochrane [ ] single-center before-after study a level i trauma center in the uk major hemorrhage protocol activation with suspicion of significant active bleeding and blood transfusion commenced teg 6s175/301 post-teg versus pre-teg (cct-based) campbell [ ] single-center before-after study a trauma center in southeast queensland australia adult trauma patients (>= 18 years or older) iss >= 12 and received blood products rotem 77/110 post-rotem versus pre-rotem unruh [ ] single-center before-after study a level i trauma center in wichita ks usa all trauma patients who underwent mtp activation teg 5000 47/67 post-teg versus pre-teg (cct-based) wang [ ] single-center retrospective study a level i trauma center in fort worth texas usa patients who sustained traumatic liver and/or spleen injuries and received any types of blood products within the first 24 h of hospital arrival teg 86/166 teg versus non-teg mohamed [ ] single-center before-after study a level i trauma center in flint mi usa aged 15 years or older with an iss of >= 15 and transfused within the first 24 h of presentation teg 47/134 post-teg versus pre-teg gonzalez [ ] single-center randomized controlled trial a level i trauma center in denver usa injured patients at least 18 years of age that met criteria for mtp activation upon ed arrival teg 5000 56/111 teg versus cct yin [ ] single-center before-after study the ed in nanjing china older than 18 years abdominal abbreviated injury scale >= 2 and requirement of 2 or more units of rbcs transfusion within 24 h of ed admission teg 5000 29/60 post-teg versus pre-teg tapia [ ] single-center before-after study a level i trauma center in houston texas usa trauma patient patients receiving 6 units or more and 10 units or more rbcs in the first 24 h aged >= 15 years teg 165/289(>= 6u rbcs); 98/163(>= 10u rbcs) teg versus mtp kashuk [ ] single-center before-after study a level trauma center in denver colorado usa patients who received 6 or more units of blood within the first 6 h teg 5000 34/68 post-teg versus pre-teg mhp major hemorrhage protocol; rbcs red blood cells; iss injury severity score; mtp massive transfusion protocol; ed emergency department; vha viscoelastic hemostatic assay; teg thrombelastography; rotem rotational thromboelastometry; cct conventional coagulation tests eight studies gave detailed rbcs plasma platelet and cryoprecipitate/fibrinogen amounts for the included patients [ - ]."

"Declarations Ethics approval and consent to participateNot applicable. Consent for publicationNot applicable. Competing interestsThe authors declare that they have no competing interests. Competing interests The authors declare that they have no competing interests."

"Funding This study was supported by the HwaMei Research Foundation of Hwa Mei Hospital, University of Chinese Academy of Sciences, China (Grant No. 2022HMKY23)."