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Initially, VET technologies such as TEG and ROTEM assessed clot formation by measuring the mechanical resistance of a pin or piston within a blood sample. Recent advances have introduced automated, cartridge\u2010based systems and novel detection methods\u2014including resonance frequency and ultrasound\u2010based sonorheometry\u2014these new systems allow for more precise, rapid, and user\u2010friendly assessment of clot dynamics at the point of care. VET is now indicated for a wide range of clinical scenarios where complex coagulopathy is anticipated, including trauma, cardiac surgery, liver transplantation, obstetric hemorrhage, and hematologic disorders such as DIC. Its use is expanding into new populations, including pediatric cardiac surgery, patients with inflammatory bowel disease, and those with COVID\u201019. However, VET remains limited in its ability to reliably detect therapeutic anticoagulants and certain congenital bleeding disorders, such as von Willebrand disease and deficiencies of protein C, S, and antithrombin. Technical limitations, including potential discrepancies between in\u00a0vitro and in\u00a0vivo clot formation, and lack of FDA approval for pediatric use have imposed implementation barriers to centers interested in pediatric VET. Looking forward, the integration of VET data with electronic medical records, the development of predictive models, artificial intelligence, and continued innovation in platelet function assessment and detection technologies are poised to enhance the clinical utility of VET. As guidelines and evidence continue to evolve, VET is positioned to become an increasingly important tool for real\u2010time, individualized management of coagulopathy in diverse patient populations.<\/jats:p>","DOI":"10.1002\/ajh.70074","type":"journal-article","created":{"date-parts":[[2025,10,4]],"date-time":"2025-10-04T08:34:01Z","timestamp":1759566841000},"page":"2357-2370","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":12,"title":["<scp>TEG<\/scp>\n                    and\n                    <scp>ROTEM<\/scp>\n                    : Technology and Clinical Applications, 2026 Update"],"prefix":"10.1002","volume":"100","author":[{"given":"Mckenna M.","family":"Longacre","sequence":"first","affiliation":[{"name":"Division of Cardiac Anesthesia, Department of Anesthesiology, Perioperative and Pain Medicine Boston Children's Hospital and Harvard Medical School  Boston Massachusetts USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2096-5363","authenticated-orcid":false,"given":"Juan C.","family":"Ibla","sequence":"additional","affiliation":[{"name":"Division of Cardiac Anesthesiology, Department of Pediatric Anesthesiology Ann &amp;Robert Lurie Children's Hospital of Chicago  Chicago Illinois USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2025,10,4]]},"reference":[{"key":"e_1_2_11_2_1","doi-asserted-by":"publisher","DOI":"10.1161\/01.CIR.19.1.92"},{"key":"e_1_2_11_3_1","doi-asserted-by":"publisher","DOI":"10.3390\/jcm11020356"},{"issue":"2","key":"e_1_2_11_4_1","first-page":"S64","article-title":"A Reduction in Clot Formation Rate and Strength Assessed by Thrombelastography Is Indicative of Transfusion Requirements in Patients With Penetrating Injuries","volume":"64","author":"Plotkin A. 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