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Rotational Thromboelastometry

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https://www.readbyqxmd.com/read/29907206/rotational-thromboelastometry-thresholds-for-patients-at-risk-for-massive-transfusion
#1
Gregory R Stettler, Ernest E Moore, Geoffrey R Nunns, Jim Chandler, Erik Peltz, Christopher C Silliman, Anirban Banerjee, Angela Sauaia
BACKGROUND: Goal-directed hemostatic resuscitation based on thrombelastography has a survival benefit compared to conventional coagulation assays. While thrombelastography transfusion thresholds for patients at risk for massive transfusion (MT) have been defined, similar cutoffs do not exist for the other commonly used viscoelastic assay, rotational thromboelastometry (ROTEM). The purpose of this study was to develop ROTEM blood product thresholds in patients at risk for MT. METHODS: ROTEM was assessed in trauma activation patients admitted from 2010 to 2016 (n = 222)...
August 2018: Journal of Surgical Research
https://www.readbyqxmd.com/read/29888855/in-vitro-studies-show-synergistic-effects-of-a-procoagulant-bispecific-antibody-and-bypassing-agents
#2
R Hartmann, T Feenstra, L Valentino, M Dockal, F Scheiflinger
BACKGROUND: Investigational non-factor products such as emicizumab offer a treatment option for patients with hemophilia and inhibitors. However, their mechanism of action raises questions regarding safety when combined with treatments for breakthrough bleeding. OBJECTIVES: Evaluate in vitro thrombin generation (TG) and clot formation for combinations of activated prothrombin complex concentrate (aPCC), recombinant activated clotting factor VII (rFVIIa), and a sequence-identical analog of emicizumab (SIA)...
June 11, 2018: Journal of Thrombosis and Haemostasis: JTH
https://www.readbyqxmd.com/read/29887293/rotational-thromboelastometry-rotem-profile-in-a-cohort-of-asystole-donors
#3
J A Barea-Mendoza, L J Terceros-Almanza, C García-Fuentes, S Bermejo-Aznárez, I J Prieto Del Portillo, C Mudarra-Reche, M Valiente-Fernández, A Rodríguez-Biendicho, J C Montejo González, M Chico-Fernández
BACKGROUND: Hypoperfusion plays a central role in shock states, and has been proposed as a coagulopathy trigger. The study of the rotational thromboelastometry (ROTEM) profile during cardiac arrest could offer new insights to the role of hypoperfusion in coagulation during shock states. OUTCOME: To describe the ROTEM profile in a cohort of asystole donors and elucidate the incidence of hyperfibrinolysis. DESIGN: A prospective observational study was carried out in 18 patients consecutively admitted to the ICU after out-of-hospital non-recovered cardiac arrest (CA)...
June 7, 2018: Medicina Intensiva
https://www.readbyqxmd.com/read/29863608/fibrinogen-concentrate-in-cardiovascular-surgery-a-meta-analysis-of-randomized-controlled-trials
#4
Jing-Yi Li, Junsong Gong, Fang Zhu, Jessica Moodie, Amy Newitt, Lavanya Uruthiramoorthy, Davy Cheng, Janet Martin
BACKGROUND: Postoperative bleeding remains a frequent complication after cardiovascular surgery and may contribute to serious morbidity and mortality. Observational studies have suggested a relationship between low endogenous plasma fibrinogen concentration and increased risk of postoperative blood loss in cardiac surgery. Although the transfusion of fibrinogen concentrate has been increasing, potential benefits and risks associated with perioperative fibrinogen supplementation in cardiovascular surgery are not fully understood...
May 31, 2018: Anesthesia and Analgesia
https://www.readbyqxmd.com/read/29846277/the-effects-of-plasma-lyte-148-solution-on-blood-coagulation-an-in-vitro-volunteer-study-using-rotational-thromboelastometry
#5
Hyun-Jung Shin, Hee-Yeon Park, Hyo-Seok Na, Jung-Pyo Hong, Gwan-Woo Lee, Sang-Hwan Do
: The current study aimed to measure the effects of Plasma-Lyte 148 solution on the blood coagulation profile according to the hemodilution level using rotational thromboelastometry (ROTEM) tests. Venous blood was collected from 12 healthy volunteers and divided into four specimen bottles, which were diluted at different levels with Plasma-Lyte 148 (0, 20, 40, and 60%). Following this, ROTEM tests were performed on the study samples. We found that as the hemodilution level increased, the ROTEM values showed a hypocoagulable pattern...
June 1, 2018: Blood Coagulation & Fibrinolysis: An International Journal in Haemostasis and Thrombosis
https://www.readbyqxmd.com/read/29805054/correction-of-coagulopathy-in-thrombocytopenia-and-glanzmann-thrombasthenia-models-by-fibrinogen-and-factor-xiii-as-assessed-by-thromboelastometry
#6
Ivan Budnik, Boris Shenkman, Olga Morozova, Jurii Andreichyn, Yulia Einav
Thrombocytopenia (TCP) and Glanzmann thrombasthenia (GT) are typical platelet disorders characterized by mild to severe bleeding. This study aims to create in vitro models of TCP and GT and to correct the impaired clot formation by fibrinogen and coagulation factor XIII. The TCP model (mean platelet count, 16 × 109 L-1 ) was produced by differential centrifugation of normal blood followed by mixing plasma with packed cells. The GT model was created by treating normal blood with 50 μg/mL eptifibatide, an inhibitor of platelet integrin αIIbβ3...
May 24, 2018: Pathophysiology: the Official Journal of the International Society for Pathophysiology
https://www.readbyqxmd.com/read/29791173/-rotational-thromboelastometry-in-therapy-of-life-threatening-bleeding
#7
Miroslav Durila
Bleeding and coagulopathy is a common problem in the fields of internal medicine. In case of life-threatening bleeding, rotational thromboelastometry (ROTEM) has critical role in diagnosis and therapy of coagulopathy. In contrast to commonly used tests such as prothrombin time and activated partial thromboplastin time, ROTEM evaluates coagulation of the whole blood as a bedside method. The use of ROTEM for rapid diagnosis and targeted therapy of coagulopathy leads to reduction in bleeding and thus to reduction in administration of blood transfusion products...
2018: Vnitr̆ní Lékar̆ství
https://www.readbyqxmd.com/read/29768939/higher-preoperative-plasma-thrombin-potential-in-patients-undergoing-surgery-for-aortic-stenosis-compared-to-surgery-for-stable-coronary-artery-disease
#8
Axel Dimberg, Ulrica Alström, Elisabeth Ståhle, Christina Christersson
Aortic stenosis (AS) and coronary artery disease (CAD) influence the coagulation system, potentially affecting hemostasis during cardiac surgery. Our aim was to evaluate 2 preoperative global hemostasis assays, plasma thrombin potential and thromboelastometry, in patients with severe aortic valve stenosis compared to patients with CAD. A secondary aim was to test whether the assays were associated with postoperative bleeding. Calibrated automated thrombogram (CAT) in platelet-poor plasma and rotational thromboelastometry (ROTEM) in whole blood were analyzed in patients scheduled for elective surgery due to severe AS (n = 103) and stable CAD (n = 68)...
January 1, 2018: Clinical and Applied Thrombosis/hemostasis
https://www.readbyqxmd.com/read/29758989/the-double-hazard-of-bleeding-and-thrombosis-in-hemostasis-from-a-clinical-point-of-view-a-global-assessment-by-rotational-thromboelastometry-rotem
#9
Olga Meltem Akay
Hemostasis is a complex dynamic process involving bleeding and thrombosis as two end-points. Conventional coagulation tests which are measured in plasma examine only isolated portions of the coagulation cascade, thereby giving no information on important interactions essential to the clinical evaluation of hemostatic function. Thromboelastography (TEG), originally described in 1948 has improved over the decades and become a valuable tool of coagulation testing because of the limitations of standard coagulation tests...
January 1, 2018: Clinical and Applied Thrombosis/hemostasis
https://www.readbyqxmd.com/read/29758126/abrogating-fibrinolysis-does-not-improve-bleeding-or-rfviia-rfviii-treatment-in-a-non-mucosal-venous-injury-model-in-haemophilic-rodents
#10
Rikke Stagaard, Matthew J Flick, Barbara Bojko, Krzysztof Goryński, Paulina Z Goryńska, Carsten D Ley, Lisbeth H Olsen, Tom Knudsen
BACKGROUND: Fibrinolysis may exacerbate bleeding in haemophilia A (HA). Accordingly, antifibrinolytics have been used to help maintain haemostatic control. While antifibrinolytic drugs have been proven effective in the treatment of mucosal bleeds in the oral cavity, their efficacy in non-mucosal tissues remain an open question of significant clinical interest. OBJECTIVE: To determine whether inhibiting fibrinolysis improves the outcome in non-mucosal haemophilic tail vein transection (TVT) bleeding models, and to determine whether a standard ex vivo clotting/fibrinolysis assay can be used as a predictive surrogate for in vivo efficacy...
May 14, 2018: Journal of Thrombosis and Haemostasis: JTH
https://www.readbyqxmd.com/read/29756268/does-rotational-thromboelastometry-accurately-predict-coagulation-status-in-patients-with-lupus-anticoagulant
#11
L Hensch, V Kostousov, K Bruzdoski, M Losos, M Pereira, M de Guzman, S Hui, J Teruya
INTRODUCTION: Rotational thromboelastometry (ROTEM) is increasingly used as a tool for monitoring coagulation status. However, ROTEM is susceptible to misinterpretation due to particular coagulation abnormalities. Here, we report the effects of lupus anticoagulant (LA) on ROTEM. METHODS: A prospective observational analysis was performed on 16 children with prior studies indicating the presence of LA or antiphospholipid antibodies. ROTEM analysis was performed, and samples were further analyzed by adding phospholipids (PL) to repeat ROTEM analysis if clotting time (CT) abnormalities were discovered with comparison to ROTEM using an equal volume of isotonic saline...
May 13, 2018: International Journal of Laboratory Hematology
https://www.readbyqxmd.com/read/29743045/haematological-and-fibrinolytic-status-of-nigerian-women-with-post-partum-haemorrhage
#12
Ian Roberts, Haleema Shakur, Bukola Fawole, Modupe Kuti, Oladapo Olayemi, Adenike Bello, Olayinka Ogunbode, Taiwo Kotila, Chris O Aimakhu, Tolulase Olutogun, Beverley J Hunt, Sumaya Huque
BACKGROUND: Early treatment with tranexamic acid reduces deaths due to bleeding after post-partum haemorrhage. We report the prevalence of haematological, coagulation and fibrinolytic abnormalities in Nigerian women with postpartum haemorrhage. METHODS: We performed a secondary analysis of the WOMAN trial to assess laboratory data and rotational thromboelastometry (ROTEM) parameters in 167 women with postpartum haemorrhage treated at University College Hospital, Ibadan, Nigeria...
May 9, 2018: BMC Pregnancy and Childbirth
https://www.readbyqxmd.com/read/29736870/can-we-predict-thrombotic-tendency-in-rheumatoid-arthritis-a-thromboelastographic-analysis-with-rotem
#13
Sümeyye Merve Türk, Döndü Üsküdar Cansu, Hava Üsküdar Teke, Timuçin Kaşifoğlu, O Meltem Akay, Muzaffer Bilgin, Cengiz Korkmaz
The higher incidence of arterial and venous events is well established in patients with rheumatoid arthritis (RA). Our aim here was to investigate whether there is a prothrombotic state in RA patients by using rotational thromboelastometry (ROTEM) method and to demonstrate whether the disease variables play a role in this process. A total of 85 patients who met the 2010 RA classification criteria were consecutively included in the study. The patients with RA who have been using antiaggregant, anticoagulant, or nonsteroidal anti-inflammatory drugs (NSAIDs) and had a history of arterial or venous thromboembolism were excluded from the study...
May 7, 2018: Clinical Rheumatology
https://www.readbyqxmd.com/read/29716485/the-effects-of-haemodilution-with-succinylated-gelatin-solution-on-coagulation-in-vitro-as-assessed-by-thromboelastometry-and-impedance-multiple-electrode-aggregometry
#14
Pca Kam, S Varanasi, K X Yang
We investigated the in vitro viscoelastic changes of progressive haemodilution with succinylated gelatin (SG) solution compared with normal saline (NS) using rotational thromboelastometry (ROTEM®). Whole blood (WB) samples obtained from 20 healthy volunteers were diluted in vitro with SG solution or NS by 10%, 20% and 40%. Fibrinogen concentration and ROTEM (EXTEM, FIBTEM) variables including coagulation time (CT), clot formation time (CFT), α-angle, and maximum clot firmness (MCF) were measured in the undiluted sample and at each degree of haemodilution...
May 2018: Anaesthesia and Intensive Care
https://www.readbyqxmd.com/read/29703920/prevalent-metabolic-derangement-and-severe-thrombocytopenia-in-abo-incompatible-liver-recipients-with-pre-transplant-plasma-exchange
#15
Hye-Mee Kwon, In-Gu Jun, JungBok Lee, Young-Jin Moon, Kyeo-Woon Jung, Hye-Won Jeong, Yong-Seok Park, Jun-Gol Song, Gyu-Sam Hwang
Desensitisation with therapeutic plasma exchange (TPE) is essential for ABO-incompatible (ABO-I) liver transplants (LTs). However, excessive citrate load and coagulation disturbances after TPE have been poorly studied, in particular in cirrhotic patients with hypocapnic alkalosis, metabolic compensation and electrolyte imbalances. We retrospectively evaluated 1123 consecutive LT recipients (923 ABO-compatible [ABO-C], 200 ABO-I) from November 2008 to May 2015. TPE was generally performed a day before LT and blood sampling was performed before anaesthesia induction...
April 27, 2018: Scientific Reports
https://www.readbyqxmd.com/read/29701562/letter-to-the-editor-rotational-thromboelastometry-guided-transfusion-protocol
#16
Thomas J Buell, Davis G Taylor, Ching-Jen Chen, Bhiken I Naik
No abstract text is available yet for this article.
April 27, 2018: Journal of Neurosurgery. Spine
https://www.readbyqxmd.com/read/29687444/thrombin-generation-potential-and-clot-forming-capacity-of-thawed-fresh-frozen-plasma-plasma-frozen-within-24-h-and-solvent-detergent-treated-plasma-octaplaslg-%C3%A2-during-5-day-storage-at-1-6%C3%A2-c
#17
A Heger, A Neisser-Svae, L Trawnicek, D Triulzi
To enable rapid availability of plasma in emergency situations, the shelf-life of thawed fresh-frozen plasma (FFP) has been extended from 24 h to 5 days. The aim of this study was to evaluate the thrombin generation (TG) potential and clot-forming ability during 5 days of refrigerated storage of thawed FFP, plasma frozen within 24 h and solvent/detergent-treated plasma octaplasLG® . During storage for 5 days, TG capacity decreased significantly over time, and rotational thromboelastometry showed significantly prolonged clotting times...
April 23, 2018: Vox Sanguinis
https://www.readbyqxmd.com/read/29683829/harmful-or-physiologic-diagnosing-fibrinolysis-shutdown-in-a-trauma-cohort-with-rotational-thromboelastometry
#18
J Carolina Gomez-Builes, Sergio A Acuna, Bartolomeu Nascimento, Fabiana Madotto, Sandro B Rizoli
BACKGROUND: Despite its central role in early trauma coagulopathy, abnormal fibrinolysis continues to be poorly understood. Excessive fibrinolysis is a known contributor to mortality. Recent studies with thromboelastography (TEG) suggest decreased fibrinolysis (or shutdown) may be just as harmful. Considering the broad use of 2 different viscoelastic assays, which are not interchangeable, we proposed for the first time to define and characterize fibrinolysis shutdown using rotational thromboelastometry (ROTEM)...
April 19, 2018: Anesthesia and Analgesia
https://www.readbyqxmd.com/read/29658985/using-rotational-thromboelastometry-clot-firmness-at-5-minutes-rotem-%C3%A2-extem-a5-to-predict-massive-transfusion-and-in-hospital-mortality-in-trauma-a-retrospective-analysis-of-1146-patients
#19
J M Kelly, S Rizoli, P Veigas, S Hollands, A Min
Viscoelastic assays such as TEG® and ROTEM® are increasingly used to guide transfusion of blood products. The EXTEM assay maximum clot firmness (MCF) is a ROTEM measure available after 25-29 min used to guide early decisions. EXTEM A10, the clot firmness at 10 min, is an accepted early surrogate, but investigators differ on whether A5, the clot firmness at 5 min, is acceptable. We re-examined this in a retrospective observational analysis of 1146 trauma patients in one centre who had ROTEM data recorded. A5 and A10 both correlated well with maximum clot firmness, with Pearson coefficients of r = 0...
April 16, 2018: Anaesthesia
https://www.readbyqxmd.com/read/29652280/relationship-between-maximum-clot-firmness-in-rotem-%C3%A2-and-postoperative-bleeding-after-coronary-artery-bypass-graft-surgery-in-patients-using-clopidogrel
#20
Rasoul Azarfarin, Fereidoon Noohi, Majid Kiavar, Ziae Totonchi, Avaz Heidarpour, Amir Hendiani, Zahra Sadat Koleini, Saeid Rahimi
Background: The aim of the present study was to investigate the relationship between maximum clot firmness (MCF) in rotational thromboelastometry (ROTEM® ) and postoperative bleeding in patients on clopidogrel after emergency coronary artery bypass graft surgery (CABG). Methods: This observational study recruited 60 patients posted for emergency CABG following unsuccessful primary percutaneous coronary intervention (PCI) while on 600 mg of clopidogrel. The study population was divided into 2 groups on the basis of their MCF in the extrinsically activated thromboelastometric (EXTEM) component of the (preoperative) ROTEM® test: patients with MCF <50 mm (n = 16) and those with MCF ≥50 mm (n = 44)...
April 2018: Annals of Cardiac Anaesthesia
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