• Matthew Self, Lucy Coupland, and Anders Aneman.
• Intevnsive Care Unit, Liverpool Hospital, South Western Sydney Local Health District, Liverpool, New South Wales, Australia.
• Acta Anaesthesiol Scand. 2025 Jan 1; 69 (1): e14533e14533.

IntroductionViscoelastic testing (VET) has been implemented in clinical care to diagnose and manage coagulation in patients with manifest or high risk of major bleeding. However, the breakdown of formed blood clots, that is, fibrinolysis, has been comparatively less studied. There is an increasing recognition that acute infections trigger a dysregulated immunothrombotic response, which has focused attention on viscoelastic testing to identify in particular fibrinolysis resistant states.MethodsThis scoping review on fibrinolysis assessment using viscoelastic testing will be conducted according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses extension for Scoping Reviews (PRISMA-ScR). Publications will be included in the review if they evaluate the fibrinolytic capacity of adult patients admitted to an intensive care unit (ICU) for acute infection (including SARS-CoV2) using VET assays that included a fibrinolytic agent. No date or language restrictions will be applied, and all study designs will be considered. A peer-reviewed search strategy will be employed in multiple electronic bibliographic databases and will also include the grey literature.ResultsThe included studies will be reported by descriptive analyses and tabulated results.ConclusionThis scoping review aims to map the research describing viscoelastic testing (VET) to assess fibrinolysis in acutely infected critically ill patients, with the goal of identifying diagnostic capabilities, any associations with patient outcomes, and the potential to guide clinical management.© 2024 Acta Anaesthesiologica Scandinavica Foundation.

9 keywords...

hide…