Viscoelastic Testing in Traumatic Brain Injury: Key Research Insights

Transfus Med Rev. 2021 Oct;35(4):108-112. doi: 10.1016/j.tmrv.2021.08.002. Epub 2021 Sep 4.

Abstract

The role of viscoelastic testing in the evaluation and management of traumatic brain injury (TBI) remains a subject of ongoing exploration. This review highlights four key publications that provide significant insights into this subject. Holcomb et al. provided early evidence of the relationship between thromboelastography (TEG) and conventional coagulation tests (CCTs). Later, Samuels et al. used TEG to identify a unique coagulopathy phenotype in TBI characterized by a notable absence of fibrinolytic abnormalities. Dixon et al. built upon these findings by exploring the application of TEG in the context of antifibrinolytic administration, noting a similar lack of effect on LY30. Finally, Guillotte et al. demonstrated the utility of TEG-PM in assessing platelet dysfunction in TBI. While these studies provide key early support for the utility of viscoelastic testing in the TBI, further exploration is needed to define evidence-based guidelines for clinical application.

Keywords: Blood coagulation; Blood transfusion; Brain injuries; Craniocerebral trauma; Fibrinolysis; Platelet transfusion; Resuscitation; Thromboelastography; Tranexamic acid; Traumatic.

Publication types

  • Review

MeSH terms

  • Antifibrinolytic Agents*
  • Blood Coagulation Disorders* / diagnosis
  • Blood Coagulation Tests
  • Brain Injuries, Traumatic* / diagnosis
  • Humans
  • Thrombelastography
  • Wounds and Injuries*

Substances

  • Antifibrinolytic Agents