# Use of viscoelastic testing in the transfusion management of burn patients: a scoping review

## TL;DR

This review explores how viscoelastic tests like TEG and ROTEM can improve transfusion decisions for burn patients compared to traditional methods.

## Contribution

The paper provides a scoping review of viscoelastic testing applications in burn transfusion management, highlighting their advantages over conventional tests.

## Key findings

- Viscoelastic tests (TEG and ROTEM) outperform conventional coagulation tests in sensitivity, specificity, and speed.
- These tests help detect both hypocoagulability and hypercoagulability in burn patients.
- Use of VETs may reduce unnecessary transfusions and improve clinical decision-making.

## Abstract

Severe burns cause complex hemostatic alterations that complicate transfusion management. Conventional coagulation tests (CCTs) have limitations in timely and accurately assessing these disorders. Viscoelastic tests (VETs), such as thromboelastography (TEG) and rotational thromboelastometry (ROTEM), allow for a dynamic and real-time evaluation of coagulation. A scoping review was conducted following the Arksey and O’Malley methodology and PRISMA-ScR guidelines. Studies from 2010 to 2025 in English or Spanish that evaluated the use of VETs in burn patients were included. Databases such as PubMed, Scopus, and ScienceDirect were analyzed. Eighteen studies were included, mostly narrative reviews and observational studies. ROTEM was the most reported test. VETs were mainly used at admission and intraoperatively. Evidence indicates that TEG and ROTEM outperform CCTs in sensitivity, specificity, and speed, allowing for reduced transfusions and detection of both hypocoagulability and hypercoagulability. VETs are promising tools for transfusion management in burn patients. Although their use is not yet standardized, they offer significant advantages over CCTs and promote more accurate clinical decisions. More studies are needed to support their systematic implementation.

Scoping Review: Use of Viscoelastic Testing in the Transfusion Management of Burn Patients. TEG = thromboelastography; ROTEM = rotational thromboelastometry; CCTs = conventional coagulation tests

Scoping Review: Use of Viscoelastic Testing in the Transfusion Management of Burn Patients. TEG = thromboelastography; ROTEM = rotational thromboelastometry; CCTs = conventional coagulation tests