Multidisciplinary perspective on the use of viscoelastic tests in clinical practice
- 2025, Volume 2 - Number 3
- Published: October 7, 2025
Multidisciplinary perspective on the use of viscoelastic tests in clinical practice
Ricardo Alonso 1, Fco. Javier Lirón 2, Cecilia Cueto-Felgueroso 3, Ma. Jesús Lorenzo 4, Gabriel Yanes 5, Sonia Veiras 6, Azucena Pajares 7, Raquel Ferrandis 7, Marta Baquero 8, Rosa Beltrao 9, Pilar Paniagua 10, Esther Méndez 11, Noelia Vilalta 12
1 Laboratorio de urgencias, Hospital Universitario y Politécnico La Fe, Valencia, España; 2 Área de Diagnóstico Biológico, Bioquímica, Hospital Universitario de La Ribera, Alzira, Valencia, España; 3 Servicio de Análisis Clínicos-Bioquímica Clínica, Hospital Universitario 12 de Octubre, Madrid, España; 4 Análisis Clínicos, Hospital Clínico Universitario de Vigo, Vigo, Pontevedra, España; 5 Servicio de Anestesia, Hospital Universitario Virgen del Rocío, Sevilla, España; 6 Servicio de Anestesia, Hospital Clínico Universitario de Santiago, Santiago de Compostela, La Coruña, España; 7 Servicio de Anestesia, Hospital Universitario y Politécnico La Fe, Valencia, España; 8 Servicio de Anestesia, Hospital Universitario Germans Trias i Pujol, Badalona, Barcelona, España; 9 ervicio de Anestesia, Hospital Universitario Germans Trias i Pujol, Badalona, Barcelona, España; 10 Servicio de Anestesia, Hospital de la Santa Creu i Sant Pau, Barcelona, España; 11 Servicio de Anestesia, Hospital Universitario de Bellvitge, L’Hospitalet de Llobregat, Barcelona, España; 12 Unidad de Hemostasia y Trombosis, Hematología, Hospital de la Santa Creu i Sant Pau, Barcelona, España
Ricardo Alonso, Fco. Javier Lirón, Cecilia Cueto-Felgueroso, Ma. Jesús Lorenzo, Gabriel Yanes, Sonia Veiras, Azucena Pajares, Raquel Ferrandis, Marta Baquero, Rosa Beltrao, Pilar Paniagua, Esther Méndez, Noelia Vilalta
La información completa de afiliaciones y autor de correspondencia está disponible en la versión original en PDF.
*Correspondence: Noelia Vilalta. Email: nvilalta@santpau.cat
Summary
Viscoelastic tests, point-of-care coagulation devices, are key tools in hemorrhage management, especially in surgery, but their use is expanding to other fields such as obstetrics, ECMO patients, and burn victims. While their role in cardiac surgery, polytrauma, and liver transplantation is more established, evidence regarding their impact on mortality remains controversial. One of the main limitations is the lack of result validation, as viscoelastic tests are not comparable to standard coagulation tests, showing significant variability (up to 83% in ROTEM®). Additionally, quality control is not always managed by the laboratory, which may affect reliability. The specialties of anesthesiology, laboratory medicine, and hematology are involved in their interpretation. This document, supported by their respective scientific societies, aims to provide a comprehensive perspective of the functionality, scientific evidence, implementation, quality control, and potential economic benefits of viscoelastic tests.
Keywords: Viscoelastic tests. Point of care. Haemostasis. Bleeding. Surgery. ECMO.
