Cochrane · systematic review · CD007871
Thromboelastography (TEG) or thromboelastometry (ROTEM) to monitor haemostatic treatment versus usual care in adults or children with bleeding
Wikkelsø, A, Wetterslev, J, Møller, AM, et al. · Cochrane Database of Systematic Reviews · 2016 · Cochrane Library
SoF tableOnly the outcomes this review put in its Summary of Findings table are listed (the Cochrane Handbook caps them at about seven per comparison). Its other analyses are not shown here.
Questions
21
current version
GRADE rated
21
No studies
0
Included studies
NR
No studies 0 · 0%Ungraded 0 · 0%Very low 0 · 0%Low 21 · 100%Moderate 0 · 0%High 0 · 0%
Ungraded means an effect was reported without a GRADE rating; it is not a gap. No studies means the review found nothing to answer the question. The six categories are a display order, not a score.
Questions and results
Current version onlyThromboelastography (TEG) or thromboelastometry (ROTEM) versus any comparison
Population: adults or children with bleeding
| Outcome | Effect | Evidence | Status / GRADE |
|---|---|---|---|
Mortality longest Thromboelastography (TEG) or thromboelastometry (ROTEM) vs any comparison | RR 0.52 [0.28, 0.95] | 8 studies · 717 participants | Low Downgraded: risk of bias, imprecision, indirectness |
Proportion of patients receiving PRBCs Thromboelastography (TEG) or thromboelastometry (ROTEM) vs any comparison | RR 0.86 [0.79, 0.94] | 10 studies · 832 participants | Low Downgraded: risk of bias, imprecision, indirectness |
Proportion of patients receiving FFP Thromboelastography (TEG) or thromboelastometry (ROTEM) vs any comparison | RR 0.57 [0.33, 0.96] | 8 studies · 761 participants | Low Downgraded: risk of bias, imprecision, indirectness |
Proportion of patients receiving platelets Thromboelastography (TEG) or thromboelastometry (ROTEM) vs any comparison | RR 0.73 [0.6, 0.88] | 10 studies · 832 participants | Low Downgraded: risk of bias, imprecision, indirectness |
Rate of surgical reintervention Thromboelastography (TEG) or thromboelastometry (ROTEM) vs any comparison | RR 0.75 [0.5, 1.1] | 9 studies · 887 participants | Low Downgraded: risk of bias, imprecision, indirectness |
Excessive bleeding events and massive transfusion Thromboelastography (TEG) or thromboelastometry (ROTEM) vs any comparison | RR 0.82 [0.38, 1.77] | 2 studies · 280 participants | Low Downgraded: risk of bias, imprecision, indirectness |
Thromboelastography (TEG) or thromboelastometry (ROTEM) compared to clinical judgement or usual care in adults or children with bleeding
Population: adults or children with bleeding
| Outcome | Effect | Evidence | Status / GRADE |
|---|---|---|---|
Mortality Thromboelastography (TEG) or thromboelastometry (ROTEM) vs clinical judgement or usual care | RR 0.81 [0.32, 2.01] | 4 studies · 445 participants | Low |
Proportion of patients receiving PRBCs Thromboelastography (TEG) or thromboelastometry (ROTEM) vs clinical judgement or usual care | RR 0.85 [0.73, 1] | 6 studies · 486 participants | Low |
Proportion of patients receiving FFP Thromboelastography (TEG) or thromboelastometry (ROTEM) vs clinical judgement or usual care | RR 0.38 [0.21, 0.68] | 4 studies · 415 participants | Low |
Proportion of patients receiving platelets Thromboelastography (TEG) or thromboelastometry (ROTEM) vs clinical judgement or usual care | RR 0.59 [0.43, 0.8] | 6 studies · 486 participants | Low |
Rate of surgical reintervention Thromboelastography (TEG) or thromboelastometry (ROTEM) vs clinical judgement or usual care | RR 0.62 [0.32, 1.2] | 5 studies · 537 participants | Low |
Thromboelastography (TEG) or thromboelastometry (ROTEM) compared to standard laboratory test (SLT)‐guided transfusion in adults or children with bleeding
Population: adults or children with bleeding
| Outcome | Effect | Evidence | Status / GRADE |
|---|---|---|---|
Mortality Thromboelastography (TEG) or thromboelastometry (ROTEM) vs standard laboratory test (SLT)‐guided transfusion | RR 0.36 [0.16, 0.84] | 4 studies · 272 participants | Low |
Proportion of patients receiving PRBCs Thromboelastography (TEG) or thromboelastometry (ROTEM) vs standard laboratory test (SLT)‐guided transfusion | RR 0.91 [0.83, 1] | 3 studies · 244 participants | Low |
Proportion of patients receiving FFP Thromboelastography (TEG) or thromboelastometry (ROTEM) vs standard laboratory test (SLT)‐guided transfusion | RR 0.83 [0.49, 1.4] | 4 studies · 346 participants | Low |
Proportion of patients receiving platelets Thromboelastography (TEG) or thromboelastometry (ROTEM) vs standard laboratory test (SLT)‐guided transfusion | RR 0.87 [0.68, 1.11] | 3 studies · 244 participants | Low |
Rate of surgical reintervention Thromboelastography (TEG) or thromboelastometry (ROTEM) vs standard laboratory test (SLT)‐guided transfusion | RR 0.82 [0.46, 1.46] | 3 studies · 248 participants | Low |
Thromboelastography (TEG) or thromboelastometry (ROTEM) in combination with SLT or other devices compared to clinical judgement or usual care in adults or children with bleeding
Population: adults or children with bleeding
| Outcome | Effect | Evidence | Status / GRADE |
|---|---|---|---|
Mortality Thromboelastography (TEG) or thromboelastometry (ROTEM) in combination with SLT or other devices vs clinical judgement or usual care | RR 0.2 [0.05, 0.75] | 2 studies · 205 participants | Low |
Proportion of patients receiving PRBCs Thromboelastography (TEG) or thromboelastometry (ROTEM) in combination with SLT or other devices vs clinical judgement or usual care | RR 0.85 [0.74, 0.98] | 3 studies · 307 participants | Low |
Proportion of patients receiving FFP Thromboelastography (TEG) or thromboelastometry (ROTEM) in combination with SLT or other devices vs clinical judgement or usual care | RR 0.46 [0.2, 1.08] | 3 studies · 307 participants | Low |
Proportion of patients receiving platelets Thromboelastography (TEG) or thromboelastometry (ROTEM) in combination with SLT or other devices vs clinical judgement or usual care | RR 0.75 [0.47, 1.2] | 3 studies · 307 participants | Low |
Rate of surgical reintervention Thromboelastography (TEG) or thromboelastometry (ROTEM) in combination with SLT or other devices vs clinical judgement or usual care | RR 0.41 [0.17, 0.96] | 4 studies · 400 participants | Low |
TEG or ROTEM versus usual care for patients with massive transfusion and coagulopathy
Population: patients with coagulopathy or massive bleeding
| Outcome | Effect | Evidence | Status / GRADE |
|---|---|---|---|
Longest TEG or ROTEM vs usual care | RR 0.77 [0.35, 1.72] | 5 studies · 473 participants | Moderate |
Longest TEG or ROTEM vs usual care | no estimate extracted | 9 studies · 776 participants | Moderate |
Proportion of patients receiving FFP TEG or ROTEM vs usual care | RR 0.64 [0.29, 1.42] | 5 studies · 579 participants | Moderate |
Proportion of patients receiving platelets TEG or ROTEM vs usual care | RR 0.77 [0.47, 1.26] | 6 studies · 619 participants | Moderate |
Combined transfusion volume (mL) of platelets TEG or ROTEM vs usual care | no estimate extracted | 6 studies · 545 participants | Moderate |
Combined transfusion volume (mL) of FFP TEG or ROTEM vs usual care | no estimate extracted | 6 studies · 545 participants | Moderate |
Rate of surgical re‐intervention: TEG or ROTEM vs control TEG or ROTEM vs usual care | RR 0.91 [0.44, 1.87] | 7 studies · 708 participants | Moderate |