Viscoelastic Hemostatic Testing as a Diagnostic Tool for Trauma-Induced Coagulopathy with a Focus on Arabian Gulf Countries: A Narrative Review
5 affiliations
- 1Anesthesia Unit, Surgery Department, King Faisal University, Hofuf 31982, Alahsa, Saudi Arabia
- 2Anesthesia Department, University of Duisburg, 45147 Essen, Germany
- 3Tem Innovations, 81829 Munich, Germany
- 4College of Medicine, King Faisal University, Hofuf 31982, Alahsa, Saudi Arabia
- 5Surgery Department, College of Medicine, King Faisal University, Hofuf 31982, Alahsa, Saudi Arabia
Abstract
Trauma-induced coagulopathy (TIC) at admission to the emergency department is associated with severe bleeding, massive transfusion, increased morbidity, and mortality. There are significant regional variations in the accessibility and acceptance of point-of-care technology, such as viscoelastic hemostatic testing (VET), for coagulation monitoring and bleeding management in the Arabian Gulf council countries (GCC). Notable regional differences among these countries are mainly due to variation in the awareness of the benefits of VET-guided bleeding management using rotational thromboelastometry (ROTEM) or thromboelastography (TEG), compared with a transfusion ratio-based approach using shock packs, rather than for economic reasons. This review highlights the superiority of VET-guided bleeding management in severe trauma over conventional coagulation tests (CCTs) for early TIC detection and the importance of monitoring hemostatic disorders, whether hypocoagulability or hypercoagulability. VET consistently outperforms traditional coagulation tests in detecting early coagulation abnormalities and predicting massive transfusion and mortality in major trauma. Besides hyperfibrinolysis, fibrinogen deficiency often represents the first issue in TIC. Recent meta-analyses consistently demonstrated a reduction in mortality by implementing VET-guided bleeding management algorithms in severe trauma. Several studies demonstrated that VETs are valuable tools for massive transfusion and mortality prediction in bleeding patients with severe trauma. There is a notable variation in VET adoption and practice across trauma settings in the Arab Gulf. GCC-specific primary evidence is limited, with the Qatar cohort representing the largest directly identified regional study.
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BibTeX
@article{yassen2026viscoelastic,
title = {{Viscoelastic Hemostatic Testing as a Diagnostic Tool for Trauma-Induced Coagulopathy with a Focus on Arabian Gulf Countries: A Narrative Review}},
author = {Khaled Ahmed Yassen and Klaus Görlinger and Lama Alzimami and Noor Salman Alswilem and Amani Almutairi and Mubarak Alsagheer and Hashim Alwayel and Ali Mousa Alkhalaf and Nour Hassan Aljamaan and Noor Alqurqush and Amnah Ali Alkhawajah and Ridha Alhussain and Sherif Saleh and Imtiyaz Ahmad Khan},
journal = {Journal of Clinical Medicine},
year = {2026},
month = oct,
doi = {10.3390/jcm15208048},
url = {https://www.mdpi.com/2077-0383/15/20/8048},
note = {CC BY 4.0},
}
RIS
TY - JOUR
TI - Viscoelastic Hemostatic Testing as a Diagnostic Tool for Trauma-Induced Coagulopathy with a Focus on Arabian Gulf Countries: A Narrative Review
AU - Khaled Ahmed Yassen
AU - Klaus Görlinger
AU - Lama Alzimami
AU - Noor Salman Alswilem
AU - Amani Almutairi
AU - Mubarak Alsagheer
AU - Hashim Alwayel
AU - Ali Mousa Alkhalaf
AU - Nour Hassan Aljamaan
AU - Noor Alqurqush
AU - Amnah Ali Alkhawajah
AU - Ridha Alhussain
AU - Sherif Saleh
AU - Imtiyaz Ahmad Khan
PY - 2026
DA - 2026/10/01
JO - Journal of Clinical Medicine
DO - 10.3390/jcm15208048
UR - https://www.mdpi.com/2077-0383/15/20/8048
AB - Trauma-induced coagulopathy (TIC) at admission to the emergency department is associated with severe bleeding, massive transfusion, increased morbidity, and mortality. There are significant regional variations in the accessibility and acceptance of point-of-care technology, such as viscoelastic hemostatic testing (VET), for coagulation monitoring and bleeding management in the Arabian Gulf council countries (GCC). Notable regional differences among these countries are mainly due to variation in the awareness of the benefits of VET-guided bleeding management using rotational thromboelastometry (ROTEM) or thromboelastography (TEG), compared with a transfusion ratio-based approach using shock packs, rather than for economic reasons. This review highlights the superiority of VET-guided bleeding management in severe trauma over conventional coagulation tests (CCTs) for early TIC detection and the importance of monitoring hemostatic disorders, whether hypocoagulability or hypercoagulability. VET consistently outperforms traditional coagulation tests in detecting early coagulation abnormalities and predicting massive transfusion and mortality in major trauma. Besides hyperfibrinolysis, fibrinogen deficiency often represents the first issue in TIC. Recent meta-analyses consistently demonstrated a reduction in mortality by implementing VET-guided bleeding management algorithms in severe trauma. Several studies demonstrated that VETs are valuable tools for massive transfusion and mortality prediction in bleeding patients with severe trauma. There is a notable variation in VET adoption and practice across trauma settings in the Arab Gulf. GCC-specific primary evidence is limited, with the Qatar cohort representing the largest directly identified regional study.
SN - 2077-0383
ER -