Individual research recommendation details

Recommendation ID

NG39/1

Question

Point-of-care coagulation testing:- What is the clinical and cost effectiveness of point-of-care coagulation testing using rotational thromboelastometry (ROTEM) or thromboelastography (TEG) to target treatment, compared with standard laboratory coagulation testing?

Any explanatory notes
(if applicable)

Why this is important:- More rapid treatment of coagulopathy could reduce mortality from haemorrhage, which is the main cause of death in patients with major trauma. Point-of-care ROTEM and TEG are complex diagnostic tools used to detect coagulopathy. They are used successfully in surgery and intensive care settings. It is thought they might also be effective in targeting treatment for coagulopathy in the resuscitation room.
Point-of-care ROTEM and TEG are faster to perform than standard laboratory tests and enable an earlier transition from an initial fixed-ratio protocol to a protocol guided by laboratory coagulation results. These results can be updated as often as every 15 minutes, which could enable treatment to be adjusted rapidly and targeted effectively. This could result in reduced use of blood components and other treatments for coagulopathy.
The costs of point-of-care ROTEM and TEG could be offset by the changes in management they lead to, which could be life-saving, and by avoidance of unnecessary transfusions.

Source guidance details

Comes from guidance

Major trauma: assessment and initial management

Number

NG39

Date issued

February 2016

Other details