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Leveraging Turbidity and Thromboelastography for Complementary Clot Characterization
Published on: June 4, 2020
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Rotational thrombelastometry: a step forward to safer patient care?
Critical Care (London, England)
|February 13, 2015
Summary
Rotational thrombelastometry (ROTEM™) shows promise in predicting thromboembolic events during non-cardiac surgery. While viscoelastic tests (VETs) are typically used for bleeding, ROTEM™ may offer a new approach for identifying clotting risks.
Area of Science:
- Anesthesiology
- Hematology
- Surgical Coagulation
Background:
- Viscoelastic tests (VETs) like rotational thrombelastometry (ROTEM™) and thrombelastography (TEG™) are primarily used to assess bleeding complications.
- Conventional coagulation tests (e.g., prothrombin time, activated partial thromboplastin time) mainly evaluate the initiation phase of hemostasis.
- VETs assess the entire clotting process, including clot kinetics and strength, reflecting interactions between procoagulants, anticoagulants, and platelets.
Purpose of the Study:
- To evaluate the potential of perioperative rotational thrombelastometry (ROTEM™) in predicting thromboembolic events.
- To explore the utility of VETs beyond bleeding assessment in surgical patients.
- To review the existing literature on VETs and hypercoagulable states for predicting postoperative thrombosis.
Main Methods:
- Retrospective analysis of perioperative ROTEM™ use in non-cardiac surgery.
- Systematic review of studies investigating VETs (ROTEM™ and TEG™) for hypercoagulable states.
- Comparison of VETs with conventional coagulation tests.
Main Results:
- Perioperative ROTEM™ predicted thromboembolic events in 90% of cases in non-cardiac surgery.
- Studies on VETs and hypercoagulable states have yielded varying results.
- A systematic review suggested further research is needed to recommend VETs for screening postoperative thrombosis.
Conclusions:
- ROTEM™ demonstrates potential as a predictive tool for thromboembolic events in non-cardiac surgery.
- Current evidence suggests VETs may have a role beyond bleeding assessment, but further validation is required.
- Additional high-quality studies are necessary to establish VETs as a reliable screening tool for predicting postoperative thrombosis.
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