Position of the French Working Group on Perioperative Haemostasis (GIHP) on viscoelastic tests: What role for which indication in bleeding situations?

Viscoelastic tests, thromboelastography and thromboelastometry are haemostatic point-of-care devices, evaluating clot formation and stability on whole blood. Clinically relevant results are obtained in 10 minutes. Their interest seems well established in severe trauma patients' care and in cardiac surgery, adult and paediatric. In other clinical situations, their interest is still a matter of debate: liver transplantation, post-partum haemorrhage and non-cardiac surgery. They must be implemented in a global haemostatic care, associated with transfusion algorithms, defined for each centre and each patient population. The localisation of these devices, bedside or in the laboratory, must be discussed with biologists.