Consequently, it is absolutely compelling to assess the available evidence on the benefit of thromboelastography in other critical patients whose bleeding is not secondary to liver transplantation, trauma or obstetric hemorrhage, based on previously asked questions, so as to select the articles in accordance with an explicit process that screens the relevant articles to answer the questions asked and hence avoid biases in selecting the articles. 2. Martini WZ, Cortez DS, Dubick MA, Park MS, Holcomb JB. Thrombelastography is better than PT, aPTT, and activated clotting time in detecting clinically relevant clotting abnormalities after hypothermia, hemorrhagic shock and resuscitation in pigs. J Trauma. 2008;65:535-13. 4. Stocks G. Monitoring transfusion requirements in major obstetric haemorrhage: out with the old and in with the new? Int J Obstet Anesth. 2011;20:275-8. 5. Schochl H, Frietsch T, Pavelka M, Jambor C. Hyperfibrinolysis after major trauma: differential diagnosis of lysis patterns and prognostic value of thrombelastometry. J Trauma. 2009;67:125-31. 6. Gálvez C, Kenny CLC. Tromboelastografía: Nuevos conceptos en la fisiología de la hemostasia y su correlación con la coagulopatía asociada al trauma. Rev Colomb Anestesiol. 2012;40. 7. Wikkelsoe AJ, Afshari A, Wetterslev J, Brok J, Moeller AM. Monitoring patients at risk of massive transfusion with thrombelastography or thromboelastometry: a systematic review. Acta Anaesthesiol Scand. 2011;55: 1174-89. 8. Sivula M, Pettila V, Niemi TT, Varpula M, Kuitunen AH. Thromboelastometry in patients with severe sepsis and disseminated intravascular coagulation. Blood Coagul Fibrinolysis. 2009;20:419-26. 9. Levi M, Schultz M, van der Poll T. Coagulation biomarkers in critically ill patients. Crit Care Clin. 2011;27: 281-97. 10. Daudel F, Kessler U, Folly H, Lienert JS, Takala J, Jakob SM. Thromboelastometry for the assessment of coagulation abnormalities in early and established adult sepsis: a prospective cohort study. Crit Care. 2009;13:R42.
En consecuencia, con lo anterior es perentorio evaluar la evidencia disponible sobre el beneficio de la utilización de la tromboelastografía en otro tipo de pacientes críticos que no sean los estados de sangrado secundarios a trasplante hepático, trauma o hemorragia obstétrica, y esto sobre la base de preguntas planteadas previamente, lo cual permitiría realizar la selección de los artículos según un proceso explícito para seleccionar los artículos que puedan contestar las preguntas planteadas, y de esa manera evitar sesgos en la selección de los artículos.