[Hemostasis management based on ROTEM(®): contra]

Area of Science:

• Anesthesiology and Critical Care Medicine
• Hematology
• Point-of-Care Diagnostics

Context:

• Perioperative hemostasis management is crucial for patient outcomes.
• Thromboelastometry, specifically ROTEM, is utilized in operating theaters for real-time hemostasis assessment.
• Therapeutic interventions are often guided by these diagnostic results.

Purpose:

• To critically evaluate the sole reliance on laboratory-based point-of-care diagnostic testing using ROTEM.
• To discuss the limitations and benefits of using ROTEM in perioperative hemostasis.
• To advocate for the appropriate integration of thromboelastometry within specialized hemostasis care.

Summary:

• This paper examines the use of rotational thromboelastometry (ROTEM) for point-of-care diagnostics during the perioperative phase.
• It argues against the exclusive use of laboratory-based ROTEM testing for clinical decision-making.
• Thromboelastometry is recommended as a supportive method, best utilized by or in close collaboration with hemostasis specialists.

Impact:

• Highlights the limitations of isolated diagnostic testing in complex hemostatic scenarios.
• Emphasizes the importance of expert interpretation in point-of-care hemostasis diagnostics.
• Promotes a collaborative approach between laboratory diagnostics and clinical hemostasis expertise for improved patient care.