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Updated: Feb 21, 2026
Leveraging Turbidity and Thromboelastography for Complementary Clot Characterization
Published on: June 4, 2020
The effect of sepsis and septic shock on the viscoelastic properties of clot quality and mass using rotational
Gareth R Davies1, Matthew Lawrence1, Suresh Pillai2
1Haemostasis Biomedical Research Unit (HBRU), Morriston Hospital, Swansea, UK; College of Medicine, Swansea University, Swansea, UK.
Purpose:
The study purpose was to define changes in coagulation across the sepsis spectrum using rotational thromboelastometry (ROTEM).
Methods:
Sepsis patients were recruited on admission to the Emergency Department and Intensive Care Units of a large teaching hospital in Wales. ROTEM markers of clot development and fibrinolysis were determined, as well as standard coagulation markers. A healthy control group matched for age and gender was also recruited (n=44).
Results:
100 patients were recruited (50 sepsis, 20 severe sepsis and 30 septic shock). Maximum clot firmness was significantly higher in the sepsis (p<0.001) and severe sepsis (p=0.012) groups than the healthy control (71.6±4.5 and 70.4±4.1 vs 64.4 respectively). In septic shock there was prolonged clot development; however, maximum clot firmness remained normal. Fibrinolytic function was significantly impaired in septic shock, which was also significantly associated with 28-day mortality (p<0.001).
Conclusions:
ROTEM indicated significantly enhanced clot structural development in sepsis and severe sepsis, which could be indicative of a hypercoagulable phase. In septic shock, despite there being a prolongation of clotting pathways and impaired fibrinolysis, clot mass was comparably normal, suggestive of the development of a clot with healthy characteristics.
