Detecting, managing and monitoring haemostasis: viscoelastometric point‑of‑care testing (ROTEM, TEG and Sonoclot systems)

Research recommendation(s) from an individual piece of guidance

Guidance:

Detecting, managing and monitoring haemostasis: viscoelastometric point‑of‑care testing (ROTEM, TEG and Sonoclot systems)

Date issued:

20 August 2014

Research recommendations coming out of this guidance

• NICE recommends further research to demonstrate the utility of the Sonoclot system in detecting, managing and monitoring haemostasis in cardiac surgery.
• NICE recommends further research in using viscoelastometric testing in the emergency control of bleeding after trauma and during postpartum haemorrhage to assess its effectiveness compared with standard laboratory testing. NICE recommends that outcomes should include, but may not be limited to, bleeding outcomes, mortality, duration of hospital or intensive care unit stay, transfusion rates and volumes transfused.
• NICE recommends further research comparing the clinical effectiveness of all 3 viscoelastometric devices (ROTEM, TEG and Sonoclot systems) in cardiac surgery and in the emergency control of bleeding after trauma and during postpartum haemorrhage. In particular, NICE recommends research to determine which of the parameters included in the viscoelastometric testing systems are the most significant in changing clinical decision-making and improving clinical outcomes. The degree of change needed in these parameters to affect clinical decision-making and clinical outcomes should also be considered.
• NICE recommends that future trials should include longer-term follow-up, beyond the initial hospital episode, with a view to informing the cost-effectiveness modelling and reducing uncertainty.
• NICE recommends further research to understand the characteristics of patients at high risk of haemostatic instability in whom viscoelastometric testing may be most cost effective.