Viscoelastic testing for hepatic surgery: a systematic review with meta-analysis—a protocolReport as inadecuate

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Systematic Reviews

, 5:151

First Online: 06 September 2016Received: 17 April 2016Accepted: 24 August 2016DOI: 10.1186-s13643-016-0326-1

Cite this article as: McCrossin, K.E., Bramley, D.E.P., Hessian, E. et al. Syst Rev 2016 5: 151. doi:10.1186-s13643-016-0326-1


BackgroundViscoelastic tests, including thromboelastography TEG and rotational thromboelastometry ROTEM, provide a global assessment of haemostatic function at the point of care. The use of a TEG or ROTEM system to guide blood product administration has been shown in some surgical settings to reduce transfusion requirements. The aim of this review is to evaluate all published evidence regarding viscoelastic testing in the setting of hepatic surgery.

MethodsWe will search MEDLINE, EMBASE and the Cochrane Central Register of Controlled Trials databases to identify randomised controlled trials examining the use of viscoelastic testing for hepatic surgery. Two reviewers will independently screen titles and abstracts of studies identified and will independently extract data. Any disagreements will be resolved by discussion with a third reviewer. A meta-analysis will be conducted if feasible.

DiscussionViscoelastic devices such as TEG and ROTEM are increasingly available to clinicians as a bedside test. Patients undergoing hepatic surgery have a significant risk of blood loss and coagulopathy requiring transfusion. Theoretical benefits of use of a TEG or ROTEM system in the hepatic surgical setting include a rationalisation of blood products, a reduction in transfusion-related side effects, an improvement in patient outcomes including mortality, and a reduction in cost. This systematic review will summarise the current evidence regarding the use of viscoelastic testing for hepatic surgery.

Systematic review registrationPROSPERO CRD42016036732

KeywordsHepatic Viscoelastic testing TEG ROTEM Surgery Anaesthesia Electronic supplementary materialThe online version of this article doi:10.1186-s13643-016-0326-1 contains supplementary material, which is available to authorized users.

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Author: Kate Elizabeth McCrossin - David Edmund Piers Bramley - Elizabeth Hessian - Evelyn Hutcheon - Georgina Imberger


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