Increasingly we are using ROTEM to determine the type and appropriate management of coagulopathy.

What is ROTEM?

Viscoelastic testing of patient blood clots – these properties correlate with quality of clotting ability of whole blood.

Why is it useful?

Haemostasis is a fine balance of pro coagulantion factors, inhibitory, fibrinolysis and cellular components.

How do you interpret it (simple version)

Clotting Time (CT) – how long it takes to clot

  • Prolonged – clotting factor deficiency (or heparin effect)
  • Treatment – FFP

Angle – velocity of clot formation

  • Problem (decreased angle) – fibrin deficiency
  • Treatment – cryoprecipitate

Amplitude – clot strength

  • Problem – (low amplitude) not forming a platelet plug – platelet problem
  • Treatment – platelets

Clot Lysis (LY30) – how much clot fibrinolysis

  • Problem – (high LY30) – increased clot lysis
  • Treatment – Tranexamic Acid (TXA)

References

  1. Practical Haemostasis
ROTEM

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