• Nicholas J Vollmer, Nicole A Leshko, Charles S Wilson, and Brian W Gilbert.
• Nicholas J. Vollmer is an emergency medicine and intensive care unit clinical pharmacy specialist at Mayo Clinic, Rochester, Minnesota.
• Crit Care Nurse. 2023 Jun 1; 43 (3): 293729-37.

BackgroundThromboelastography is a viscoelastic test with multiple potential advantages over conventional coagulation tests in various disease states. Thromboelastography rapidly provides qualitative and quantitative information related to a patient's coagulation status.ObjectiveTo describe recent studies of the use of thromboelastography in various clinical states and how thromboelastography is used in coagulation management.MethodsA literature review using the MEDLINE and PubMed databases was conducted. The updated methodology for integrated reviews by Whittemore and Knafl was followed. Coauthors evaluated separate areas that were independently reviewed by other coauthors to ensure appropriateness for inclusion.ResultsThe use of thromboelastography for various clinical conditions with challenging hemostatic profiles has increased. This integrative review covers the use of thromboelastography in patients with trauma, medication-induced coagulopathy, acute and chronic liver failure, and cardiothoracic surgery. Potential future directions are also discussed.DiscussionThromboelastography has numerous potential benefits over conventional coagulation tests for assessing coagulation status in patients in various clinical states. Nurses can support clinical decisions to use the most appropriate test for their patients.ConclusionsEach team member should be involved in assessing the usefulness of thromboelastography. Critical care nurses and the multidisciplinary team must identify patients in whom its use is warranted, interpret the results, and provide appropriate interventions in response to the results and clinical status of the patient.©2023 American Association of Critical-Care Nurses.

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