Viscoelastic Hemostatic Assessment in Polytrauma

Abstract

Polytrauma is frequently accompanied by the early development of trauma-induced coagulopathy (TIC), which may occur within minutes after injury and has a significant impact on the severity of shock and patient survival. The pathogenesis of this condition is primarily driven by the combination of tissue injury and hemorrhagic shock, which triggers endogenous coagulopathy, systemic anticoagulation, and hyperfibrinolysis. Subsequent blood loss, hypothermia, acidosis, and hemodilution further exacerbate coagulation disturbances, creating a self-perpetuating cycle that results in severe hemostatic dysfunction. Viscoelastic assays, particularly thromboelastography (TEG) and rotational thromboelastometry (ROTEM), enable rapid assessment of the functional status of coagulation in whole blood and are widely used for the early detection of hypocoagulability, hyperfibrinolysis, and fibrinogen deficiency.