Use of viscoelastic testing in the transfusion management of burn patients: a scoping review.

IF 2.2 3区医学 Q2 CARDIAC & CARDIOVASCULAR SYSTEMS

Journal of Thrombosis and Thrombolysis Pub Date : 2025-09-11 DOI:10.1007/s11239-025-03173-4

Mariana Garay Álvarez, Giovanni Rodríguez Rojas, María Alejandra Triana Sutachan, Erwin Hernando Hernández Rincón

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引用次数: 0

Abstract

Severe burns cause complex hemostatic alterations that complicate transfusion management. Conventional coagulation tests (CCTs) have limitations in timely and accurately assessing these disorders. Viscoelastic tests (VETs), such as thromboelastography (TEG) and rotational thromboelastometry (ROTEM), allow for a dynamic and real-time evaluation of coagulation. A scoping review was conducted following the Arksey and O'Malley methodology and PRISMA-ScR guidelines. Studies from 2010 to 2025 in English or Spanish that evaluated the use of VETs in burn patients were included. Databases such as PubMed, Scopus, and ScienceDirect were analyzed. Eighteen studies were included, mostly narrative reviews and observational studies. ROTEM was the most reported test. VETs were mainly used at admission and intraoperatively. Evidence indicates that TEG and ROTEM outperform CCTs in sensitivity, specificity, and speed, allowing for reduced transfusions and detection of both hypocoagulability and hypercoagulability. VETs are promising tools for transfusion management in burn patients. Although their use is not yet standardized, they offer significant advantages over CCTs and promote more accurate clinical decisions. More studies are needed to support their systematic implementation.

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粘弹性试验在烧伤患者输血管理中的应用：范围综述。

严重烧伤引起复杂的止血改变，使输血管理复杂化。常规凝血试验（CCTs）在及时准确评估这些疾病方面存在局限性。粘弹性测试（vet），如血栓弹性成像（TEG）和旋转血栓弹性测量（ROTEM），允许动态和实时的凝血评估。根据Arksey和O'Malley方法和PRISMA-ScR指南进行了范围审查。2010年至2025年的英语或西班牙语研究评估了烧伤患者使用vet的情况。分析了PubMed、Scopus和ScienceDirect等数据库。纳入了18项研究，主要是叙述性综述和观察性研究。ROTEM是报道最多的测试。VETs主要用于入院和术中。有证据表明，TEG和ROTEM在敏感性、特异性和速度上都优于cct，可以减少输血量，同时检测低凝性和高凝性。兽医是烧伤患者输血管理的有前途的工具。尽管它们的使用尚未标准化，但与有条件现金转移治疗相比，它们具有显著优势，并促进了更准确的临床决策。需要更多的研究来支持它们的系统实施。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Journal of Thrombosis and Thrombolysis 医学-外周血管病

CiteScore

9.20

自引率

0.00%

发文量

112

审稿时长

4-8 weeks

期刊介绍： The Journal of Thrombosis and Thrombolysis is a long-awaited resource for contemporary cardiologists, hematologists, vascular medicine specialists and clinician-scientists actively involved in treatment decisions and clinical investigation of thrombotic disorders involving the cardiovascular and cerebrovascular systems. The principal focus of the Journal centers on the pathobiology of thrombosis and vascular disorders and the use of anticoagulants, platelet antagonists, cell-based therapies and interventions in scientific investigation, clinical-translational research and patient care. The Journal will publish original work which emphasizes the interface between fundamental scientific principles and clinical investigation, stimulating an interdisciplinary and scholarly dialogue in thrombosis and vascular science. Published works will also define platforms for translational research, drug development, clinical trials and patient-directed applications. The Journal of Thrombosis and Thrombolysis'' integrated format will expand the reader''s knowledge base and provide important insights for both the investigation and direct clinical application of the most rapidly growing fields in medicine-thrombosis and vascular science.