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VEM was used to monitor the patient\u2019s coagulopathy and to inform treatment measures by allowing real-time visualisation of the patient\u2019s coagulation status. VEM was additionally used to direct blood product replacement in preparation for neurosurgical intervention, and 4-factor prothrombin complex concentrate (PCC) was used to help reverse the coagulopathy. The patient underwent successful hemicraniectomy after improvement of his coagulopathy. In paediatrics, VEM and PCC are increasingly being used for post-trauma coagulopathy, and this case highlights their potential promise and the need for further research.<\/jats:p>","DOI":"10.1136\/bcr-2020-236608","type":"journal-article","created":{"date-parts":[[2020,12,13]],"date-time":"2020-12-13T23:30:23Z","timestamp":1607902223000},"page":"e236608","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":2,"title":["Use of viscoelastic monitoring and prothrombin complex concentrate in a paediatric patient with polytrauma and severe traumatic brain injury"],"prefix":"10.1136","volume":"13","author":[{"given":"Eric A","family":"Sribnick","sequence":"first","affiliation":[{"name":"Department of Neurosurgery, Nationwide Children's Hospital, Columbus, Ohio, USA"},{"name":"Deparmtent of Neurosurgery, The Ohio State University College of Medicine, Columbus, Ohio, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nicole","family":"Wenger","sequence":"additional","affiliation":[{"name":"The Ohio State University College of Medicine, Columbus, Ohio, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kathleen","family":"Nicol","sequence":"additional","affiliation":[{"name":"Deaprtment of Pathology and Laboratory Medicine, Nationwide Children's Hospital, Columbus, Ohio, USA"},{"name":"Department of Pathology, The Ohio State University College of Medicine, Columbus, Ohio, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Joseph D","family":"Tobias","sequence":"additional","affiliation":[{"name":"Department of Anesthesiology and Pain Medicine, Nationwide Children's Hospital, Columbus, Ohio, USA"},{"name":"Depatment of Anesthesiology and Pain Medicine, The Ohio State University College of Medicine, Columbus, Ohio, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"239","published-online":{"date-parts":[[2020,12,13]]},"reference":[{"key":"2025082713062979000_13.12.e236608.1","doi-asserted-by":"publisher","DOI":"10.1007\/s00701-007-1475-8"},{"key":"2025082713062979000_13.12.e236608.2","doi-asserted-by":"publisher","DOI":"10.1227\/NEU.0b013e31824d179b"},{"key":"2025082713062979000_13.12.e236608.3","doi-asserted-by":"crossref","first-page":"508","DOI":"10.1097\/SLA.0000000000002355","article-title":"Trending fibrinolytic dysregulation: fibrinolysis shutdown in the days after injury is associated with poor outcome in severely injured children","volume":"266","author":"Leeper","year":"2017","journal-title":"Ann Surg"},{"key":"2025082713062979000_13.12.e236608.4","doi-asserted-by":"publisher","DOI":"10.1007\/s12028-014-0051-3"},{"key":"2025082713062979000_13.12.e236608.5","doi-asserted-by":"publisher","DOI":"10.1016\/j.resuscitation.2007.06.024"},{"key":"2025082713062979000_13.12.e236608.6","doi-asserted-by":"crossref","first-page":"625","DOI":"10.1016\/j.jamcollsurg.2016.12.046","article-title":"Prevalence and impact of admission acute traumatic coagulopathy on treatment intensity, resource use, and mortality: an evaluation of 956 severely injured children and adolescents","volume":"224","author":"Liras","year":"2017","journal-title":"J Am Coll Surg"},{"key":"2025082713062979000_13.12.e236608.7","doi-asserted-by":"publisher","DOI":"10.1016\/j.tmrv.2011.07.005"},{"key":"2025082713062979000_13.12.e236608.8","doi-asserted-by":"publisher","DOI":"10.1055\/s-0030-1265289"},{"key":"2025082713062979000_13.12.e236608.9","doi-asserted-by":"publisher","DOI":"10.1186\/1757-7241-20-15"},{"key":"2025082713062979000_13.12.e236608.10","doi-asserted-by":"crossref","first-page":"954","DOI":"10.2174\/1389450117666160310153211","article-title":"Targeted thromboelastographic (TEG) blood component and pharmacologic hemostatic therapy in traumatic and acquired coagulopathy","volume":"17","author":"Walsh","year":"2016","journal-title":"Curr Drug Targets"},{"key":"2025082713062979000_13.12.e236608.11","doi-asserted-by":"publisher","DOI":"10.1097\/CCM.0b013e3182281af5"},{"key":"2025082713062979000_13.12.e236608.12","doi-asserted-by":"crossref","first-page":"394","DOI":"10.1160\/TH08-06-0383","article-title":"Point-Of-Care versus central laboratory coagulation testing during haemorrhagic surgery. 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