Abstract
Viscoelastic-based techniques to evaluate whole blood hemostasis have advanced substantially since they were first developed over 70 years ago but are still based upon the techniques first described by Dr. Hellmut Hartert in 1948. Today, the use of thromboelastography, the method of testing viscoelastic properties of blood coagulation, has moved out of the research laboratory and is now more widespread, used commonly during surgery, in emergency departments, intensive care units, and in labor wards. Thromboelastography is currently a rapidly growing field of technological advancement and is attracting significant investment. This review will first describe the history of the viscoelastic testing and the established first-generation devices, which were developed for use within the laboratory. This review will then describe the next-generation hemostasis monitoring devices, which were developed for use at the site of care for an expanding range of clinical applications. This review will then move on to experimental technologies, which promise to make viscoelastic testing more readily available in a wider range of clinical environments in the endeavor to improve patient care.
Highlights
The use of techniques to evaluate hemostasis utilizing the viscoelastic properties of whole blood have been reported since the 1940s
This review will first describe the history of the viscoelastic testing and the established first-generation devices, which were developed for use within the laboratory
This review will describe the next-generation hemostasis monitoring devices, which were developed for use at the site of care for an expanding range of clinical applications
Summary
The use of techniques to evaluate hemostasis utilizing the viscoelastic properties of whole blood have been reported since the 1940s. The use of today’s standard hemostatic assays (prothrombin time, activated partial thromboplastin, international normalized ratio, etc.) became common. These assays only shed light on a small part of the overall hemostasis process. Instrumentation quality and ease of use has improved dramatically. The current technological landscape has a host of new technologies being developed to improve the capability of the instrumentation and bring it closer to the site of care
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