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In Vitro Thrombosis Test for Ventricular Assist Devices
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Alterations in rotation thromboelastometry (ROTEM®) parameters: point-of-care testing vs analysis after pneumatic
J Martin1, T Schuster, G Moessmer
1Klinik für Anaesthesiologie, Technische Universität München, Klinikum rechts der Isar, Ismaninger Strasse 22, 81675 München, Germany. j.martin@lrz.tum.de
British Journal of Anaesthesia
|July 7, 2012
Summary
Pneumatic tube system (PTS) transport of blood samples for thromboelastometry is a viable alternative to bedside testing in patients with normal hemostasis, showing minimal, clinically insignificant alterations in clotting parameters.
Area of Science:
- Clinical Pathology
- Hemostasis and Thrombosis
- Point-of-Care Testing
Background:
- Point-of-care (POC) thromboelastometry offers rapid bedside analysis for guiding hemostatic therapy.
- Challenges exist in POC testing due to limited trained personnel managing critically ill patients.
- Central laboratory analysis via pneumatic tube system (PTS) transport is an alternative to bedside POC testing.
Purpose of the Study:
- To compare thromboelastometry parameters of blood samples analyzed immediately versus after PTS transport.
- To assess the clinical implications of delayed analysis in patients with normal hemostasis.
Main Methods:
- Two arterial blood samples were collected from 92 patients with normal hemostasis.
- One sample was analyzed immediately, the other after PTS transport using ROTEM®.
- Assays included INTEM, EXTEM, and FIBTEM.
Main Results:
- PTS transport resulted in significantly lower mean clot firmness in INTEM and EXTEM assays.
- INTEM coagulation time (CT) was significantly lower in PTS samples (-13s).
- EXTEM CT was significantly higher in PTS samples (+3.9s).
Conclusions:
- Thromboelastometry parameters are altered after PTS transport compared to immediate analysis.
- Alterations in patients with normal hemostasis were small and clinically insignificant.
- PTS transport is an acceptable alternative to bedside analysis for normal hemostasis; further study is needed for impaired hemostasis.
