Pro: Point-of-care Viscoelastic Testing Should Be Routinely Used in All Cardiac Surgery Patients.

This "Pro" argument supports the routine incorporation of point-of-care viscoelastic testing (VET) into perioperative bleeding management algorithms for all cardiac surgery patients. This group of patients remains among the highest consumers of allogeneic blood products, and transfusion is independently associated with increased morbidity, mortality, and cost. Standard laboratory tests have significant limitations in diagnosing coagulopathy and are not designed to guide intraoperative bleeding management. VET enables rapid identification of specific coagulation abnormalities and supports targeted hemostatic therapy. Current evidence demonstrates reductions in transfusion requirements, postoperative bleeding, acute kidney injury, and healthcare costs when VET is integrated into structured transfusion algorithms. Although limitations exist, the available evidence and contemporary guidelines support the routine implementation of VET in cardiac surgical programs.