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)