2. Details of interventional algorithms.

Author/year	Duration of intervention	Devices used	RBC trigger	FFP trigger	PLT trigger	Protamine trigger	Cryo or fib.conc. trigger	Antifibrinolytics trigger
Ak 2009	Intraoperative and until 24 hours post‐CPB	TEG	Hct < 25% (18% accepted during CPB)	TEG‐R > 14 min	TEG‐MA < 48 mm	h‐TEG‐R < 0.5 x TEG‐R	‐	LY30 > 7.5%
Avidan 2004*	Intraoperative and until 2 hours post‐CPB	TEG and PFA‐100 and Hepcon device	hb < 8g/dL	TEG‐R > 10 min (no heparin effect) and bleeding	Prolonged PFA‐100 channel closure time and persisting bleeding	Hepcon measurement	‐	LY30 > 7.5% and bleeding > 100 mL/hour
Cui 2010	Unclear	TEG, kaolin activated and functional fibrinogen	No trigger stated, the Hct was higher than 54% before operation	Not described	Not described	Protamine at standard dose (4 mg/kg)	Fibrinogen concentrate to all in TEG group 500 mg to 1000 mg	Not described
Girdauskas 2010**	Intra‐ and postoperative	ROTEM (HEPTEM, APTEM, FIBTEM, INTEM)	Hct < 25% (hb < 8.5 g/dL) (20% (hb 6.8 g/dL) accepted during CPB) or severe haemodynamic instability	HEPTEM‐CT > 260 sec	HEPTEM‐MCF = 35‐45 mm and FIBTEM‐MCF > 8 mm or HEPTEM‐MCF < 35 mm	INTEM‐CT/HEPTEM‐CT > 1.5	FIBTEM‐MCF < 8 mm	APTEM‐MCF /HEPTEM‐MCF > 1.5 (if needed beyond standard protocol)
Kempfert 2011	Unclear	ROTEM (4 chamber)	Not stated	Not described	Not described	Not described	Not described	Not described
Kultufan Turan 2006	Intra‐ and postoperative	ROTEG	Details not available	Details not available	Details not available	Details not available	‐	Details not available
Nakayama 2015	Intraoperative	ROTEM (HEPTEM, APTEM, FIBTEM, INTEM, EXTEM)	Maintain the haematocrit at 25% to 30% during CPB	EXTEM‐A10 < 30 mm and FIBTEM‐A10 ≤ 5mm	EXTEM‐A10 ≤ 30 mm and FIBTEM‐A10 > 5mm	HEPTEM‐CT/INTEM‐CT < 0.8	Not available	Not described
NCT00772239	Unclear	ROTEM	Unclear	Unclear	Unclear	Unclear	Unclear	Unclear
Nuttal 2001	Intraoperative	TEG, Coaguchek Plus and Coulter‐MDII	Details not available	PT > 16.6 sec or aPTT > 57 sec	TEG‐MA < 48 mm or platelet count < 102,000/µL	ACT‐guided	p‐fibrinogen < 144 mg/dL	At the discretion of the anaesthesiologist
Paniagua 2011	Intra‐ and postoperative	ROTEM (HEPTEM, FIBTEM, INTEM, EXTEM, APTEM)	Hb < 8 g/dL	First line: EXTEM‐CT > 80 S or HEPTEM‐CT > 280 S and INTEM‐CT > 240 S Second line: EXTEM‐MCF < 50 mm and FIBTEM‐MCF < 12 mm	EXTEM‐MCF < 50 mm and FIBTEM‐MCF > 12 mm*	INTEM‐CT > 240 sec and HEPTEM‐CT normal	One patient in the ROTEM group received fibrinogen concentrate. The drug was only available during the last three months of inclusions	EXTEM‐CT >80 S, CFT > 159, EXTEM‐MCF < 50 mm and/or Lysis at 1 hour > 15%
Rauter 2007	Unclear	ROTEM	Unclear	Unclear	Unclear	Unclear	Unclear	Unclear
Royston 2001	Intraoperative	TEG and h‐TEG	Details not available	h‐TEG‐R > 14 min	h‐TEG‐MA < 48 mm	Details not available	‐	LY30 > 7.5%
Schaden 2012	Intra‐ and postoperative	ROTEM (APTEM, FIBTEM, EXTEM)	Hb < 8 g/dL	EXTEM‐CT > 100 S	EXTEM‐A10 < 45 mm and FIBTEM‐A10 > 12 mm	Not relevant	EXTEM‐A10 < 45 mm and FIBTEM‐A10 < 12 mm	Spindle‐shaped trace Or APTEM‐A10 >> EXTEM‐A10 or EXTEM‐LY30 > 10 %
Shore‐Lesserson 1999	Intraoperative	TEG and h‐TEG	Hct < 25% (21% accepted during CPB) and bleeding (> 100 mL in 3 min or absence of visible clots)	h‐TEG‐R > 20 min and bleeding (> 100 mL in 3 min or absence of visible clots)	TEG‐MA < 45 mm and platelet count < 100,000/µL and bleeding (> 100 mL in 3 min or absence of visible clots)	TEG‐R > 2 x h‐TEG‐R	p‐fibrinogen < 100 mg/dL and bleeding (> 100 mL in 3 min or absence of visible clots)	LY30 > 7.5% (if needed beyond standard protocol)
Wang 2010	Unclear/most likely only intraoperative	TEG	hb < 8 g/dL	TEG‐R > 10 min	TEG‐MA < 55 mm	‐	TEG‐alpha‐angle < 45 degrees	LY30, no limit stated
Weber 2012	Intra‐ and postoperative	ROTEM (HEPTEM, FIBTEM, INTEM, EXTEM)	Hb < 6 g/dL during CPB and < 8 g/dL after CPB	EXTEM‐CT > 80 S or HEPTEM‐CT > 240 S	EXTEM‐A10 < 40 mm and FIBTEM‐A10 > 10 mm or MULTIPLATE (TRAP < 50 AU and/or ASPI < 30 AU and/or ADP < 30 AU*)	ACT > 130 and INTEM‐CT > 240 sec and HEPTEM‐CT/INTEM‐CT < 0.8	EXTEM‐A10 < 40 mm and FIBTEM –A10 < 10 mm	Antifibrinolytic therapy consisted of the application of 2 g tranexamic acid after the induction of anaesthesia, and another 2 g was added into the priming volume of the heart–lung machine and again during CPB
Westbrook 2009	Intra‐ and postoperative	TEG, h‐TEG and Platelet Mapping	hb < 7 g/dL	h‐TEG‐R > 11 min and persisting bleeding (> 60 mL in first 30 min after protamine or > 60 mL/hour in ICU)	h‐TEG‐MA ≤ 41 mm and persisting bleeding (> 60 mL in first 30 min after protamine or > 60 mL/hour in ICU)	TEG‐R –h‐TEG‐R ≥ 3 min	h‐TEG‐MA > 45 and ‐TEG‐alpha‐angle < 45 degrees	LY30 > 15%

*In addition: prothrombin complex concentrate if APTEM‐CT > 120 sec; **in addition: desmopressin if persisting bleeding and prolonged PFA‐100 channel closure time; ***in addition: desmopressin singular therapy approach for first time confirmed platelet dysfunction.
 ‐A10: ROTEM value measured early at 10 min; ACT: activated clotting time; ADP: multiplate test; APTEM: aprotinin test of ROTEM; aPTT: activated partial thromboplastin time; ASPI: multiplate test; AU: arbitrary aggregation units; CPB: cardiopulmonary bypass; ‐CT: clot formation time; EXTEM: extrinsic system screen test; FFP: fresh frozen plasma; FIBTEM: fibrinogen test of ROTEM; h‐: heparin cup; hb: haemoglobin; Hct: haematocrit; HEPTEM: heparin test of ROTEM; ICU: intensive care unit; INTEM: intrinsic system screen test; LY30: Lysis time at 30 min; ‐MCF: maximum clot firmness; p‐: plasma; PLT: platelet transfusion data; PT: prothrombin time; RBC: red blood cell; ROTEG: rotational TEG; ROTEM: rotational thromboelastometry; TEG: thromboelastography; TEG‐R: thromboelastography reaction time; TEG‐MA: thromboelastography maximum amplitude; TRAP: thrombin receptor activating peptide multiplate test;