Table 2.

Viscoelastic tests available for the pediatric trauma population.

Test		Definition	Hemostatic phase	Cause for abnormalities	Intervention	Studies on the use of viscoelastic tests after pediatric trauma
TEG® Assay time: 10-15 min	RoTEM® Assay time: 5-10 min					TEG®	RoTEM®
R	CT	Time from initiation of test until the beginning of the clot formation	Initiation of coagulation	Prolonged R/CT: -Factor deficiencies -Anticoagulants Short R/CT: -Plasma hypercoagulability	Plasma	Admission rapid TEG results correlate with conventional coag tests and predict early transfusion, early LSI and outcome. [58] Report on TEG guided hemostatic resuscitation [135]	Age related reference ranges established in children [61] Report on Successful RoTEM-guided Hemostatic therapy after blunt trauma. [80]
K	CFT	Time from start of the clot formation to the curves reaches amplitude of 20 mm	Amplification of coagulation	Prolonged K/CFT: -Factor deficiencies -Hypofibrinogenaemia -Thrombocytopenia -Platelet dysfunction	Cryoprecipitate
α	α	Angle between baseline and the tangent to the curve through the starting point of coagulation	Propagation of coagulation ‘Thrombin burst’	Low α -Factor deficiencies -Hypofibrinogenaemia -Thrombocytopenia -Platelet dysfunction	Cryoprecipitate
MA	MCF	Amplitude measured at max curve width		Low MA/MCF -Hypofibrinogenaemia -Thrombocytopenia -Platelet dysfunction -FXIII deficiency	Platelets (consider FXIII concentrate if ongoing bleeding and persistently low MA/MCF)
LY	ML	Reduction in area under curve (LY) or in amplitude (ML) from the time MA/MCF is achieved until 30 or 60 min after MA/MCF	Fibrinolysis	Increased LY/ML - Hyperfibrinolysis	Antifibrinolytics

Table modified from [136]