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Related Experiment Video

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Can rotational thromboelastometry predict septic disseminated intravascular coagulation?

Hiroyuki Koami1, Yuichiro Sakamoto, Miho Ohta

  • 1Center for Emergency and Critical Care Medicine, Saga University Hospital, Saga, Japan.

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Rotational thromboelastometry (ROTEM) effectively diagnoses sepsis-induced disseminated intravascular coagulation (DIC). The EXTEM Clotting Time (CT) using ROTEM is a reliable indicator of septic DIC severity.

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Area of Science:

  • Critical Care Medicine
  • Hematology
  • Point-of-Care Testing

Background:

  • Rotational thromboelastometry (ROTEM) is a point-of-care test used in postsurgical management.
  • The diagnostic utility of ROTEM for sepsis-induced disseminated intravascular coagulation (DIC) remains under-investigated.

Purpose of the Study:

  • To investigate the utility of ROTEM for the rapid diagnosis of sepsis-induced DIC.
  • To assess the correlation between ROTEM parameters and the Japanese Association for Acute Medicine (JAAM) DIC score.

Main Methods:

  • Retrospective study of 13 sepsis patients who underwent ROTEM.
  • Patients were categorized into DIC and non-DIC groups based on the JAAM DIC score.
  • Analysis included demographics, clinical characteristics, laboratory data, ROTEM tests, and outcomes, with correlation and ROC analyses.

Main Results:

  • The DIC group exhibited significantly longer prothrombin times, INR, and EXTEM Clotting Times (CT), along with higher fibrinogen, FDPs, and D-dimer levels.
  • EXTEM CT showed a strong correlation with the JAAM DIC score (r = 0.798).
  • EXTEM CT accurately predicted septic DIC with an AUC of 0.952, a sensitivity of 100.0%, and a specificity of 83.3% at a cut-off of >46.0 s.

Conclusions:

  • EXTEM CT is a reliable indicator for diagnosing sepsis-induced DIC based on the JAAM DIC score.
  • EXTEM CT is strongly associated with the severity of sepsis-induced DIC.
  • ROTEM offers a valuable tool for rapid DIC assessment in sepsis patients.