Viscoelastic Assay Testing for the Treatment of Coagulopathy and Reduction of Hemorrhagic Complications in Patients with Traumatic Brain Injury : A Scoping Review of the Literature

Introduction: Patients with traumatic brain injury (TBI) exhibit varying degrees of coagulopathy that place them at elevated risk for extension of intracranial hemorrhage (ICH). The objective of this review is to summarize current evidence for the utilization of viscoelastic assays, such as thromboelastography (TEG) and rotational thromboelastometry (ROTEM), to detect and treat coagulopathy for the purpose of reducing the risk of ICHrelated complications. Inclusion criteria: Eligible papers will be original research articles published in peer-reviewed journals that report both the use of viscoelastic assays and ICH-related outcomes in adults with TBI. Papers reporting pediatric populations, causes of injury other than blunt or penetrating mechanisms, animal research, or papers published in languages other than English will be excluded. Methods: A comprehensive search strategy using a combination of MeSH terms and keywords, developed in conjunction with a librarian, will be applied to MEDLINE (Pubmed), EMBASE, and CINAHL. Two authors will then screen each paper title and abstract for broad eligibility. Two authors will screen all full-text records for inclusion to develop the final set of articles. The application of viscoelastic assays and associations with ICH-related outcomes among patients with TBI will be summarized.