title: Viscoelastic hemostatic assays in the management of the pediatric trauma patient.
abstract: Viscoelastic hemostatic assays (VHA), such as TEG and ROTEM, are whole blood tests that depict functional coagulation both numerically and graphically. The development of rapid VHA technology, which allows for the first data points to result within minutes of test initiation, has increased the utility of these tests in the treatment of trauma patients. Both adult and pediatric centers have integrated VHAs into trauma resuscitation and transfusion protocols. Literature regarding the use of VHAs for injured children is limited. Here, we discuss the mechanics and interpretation of VHAs as well as the use of VHAs in data-driven resuscitation of pediatric trauma patients. Novel research on fibrinolysis states after injury as well as hypercoagulable state diagnosed with VHAs are presented.
authors.affiliation: Department of Surgery, University of Pittsburgh School of Medicine, Children's Hospital of Pittsburgh of UPMC, 7th Floor, Faculty Pavilion, One Children's Hospital Dr, 4401 Penn Ave, Pittsburgh, Pennsylvania 15224.
authors.forename: Christine M
authors.initials: CM
authors.lastname: Leeper
authors.affiliation: Department of Surgery, University of Pittsburgh School of Medicine, Children's Hospital of Pittsburgh of UPMC, 7th Floor, Faculty Pavilion, One Children's Hospital Dr, 4401 Penn Ave, Pittsburgh, Pennsylvania 15224. Electronic address: Barbara.Gaines@chp.edu.
authors.forename: Barbara A
authors.initials: BA
authors.lastname: Gaines
mesh_terms: D001778:Blood Coagulation Disorders / Q000097:blood / Q000175:diagnosis* / Q000209:etiology; D001780:Blood Coagulation Tests / Q000379:methods*; D004548:Elasticity; D006487:Hemostasis; D006801:Humans; D014947:Wounds and Injuries / Q000097:blood / Q000150:complications*
keywords: Coagulopathy; Pediatric; Thromboelastography; Transfusion; Trauma