Hemodynamics, fluids & transfusion
Viscoelastic haemostatic assays to guide therapy in elective surgery: an updated systematic review and meta‐analysis
Authors' conclusion
Viscoelastic haemostatic assay-guided therapy may reduce peri-operative blood product transfusion requirements and blood loss during major elective surgery, with no discernible effect on patient-centred outcomes.
Study context
- Population
- Patients undergoing elective major surgery20 RCTs
- Comparison
- Viscoelastic haemostatic assay-guided therapy vs control
- Outcome
- Blood product requirements; duration of stay in the operating theatre or ICU; surgical reintervention rate
Methodological detailsOverall risk of bias low to moderate
- Overall risk of bias low to moderate
Pooled result
As reported in the abstract
Viscoelastic haemostatic assay-guided therapySMD (95% CI)
Transfusion of platelets
−0.33(−0.56 to −0.10)
Transfusion of FFP
−0.64(−1.01 to −0.28)
Viscoelastic haemostatic assay-guided therapyRelative risk (95% CI)
Surgical reintervention; no evidence of an effect
1.09(0.70–1.69)
- Transfusion of RBC; reported as a statistically significant reduction
- SMD 0.16 (95% CI −0.29 to 0.02)
Further pooled results
Blood loss
- Lower blood loss with VHA-guided therapy
Total LOS and all-cause mortality
- No evidence of any effect
Original publication
Viscoelastic haemostatic assays to guide therapy in elective surgery: an updated systematic review and meta‐analysis. Anaesthesia. Published 14 November 2024. doi:10.
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