Rotational thromboelastometry (ROTEM) profile in a cohort of asystole donors

Area of Science:

• Critical Care Medicine
• Hemostasis and Thrombosis
• Emergency Medicine

Background:

• Hypoperfusion is a key factor in shock and may trigger coagulopathy.
• Rotational thromboelastometry (ROTEM) can provide insights into coagulation during shock states, particularly in cardiac arrest (CA).

Purpose of the Study:

• To characterize the ROTEM profile in patients experiencing out-of-hospital non-recovered cardiac arrest.
• To determine the incidence of hyperfibrinolysis in this patient cohort.

Main Methods:

• A prospective observational study involving 18 patients admitted to the ICU after non-recovered out-of-hospital CA.
• Conventional coagulation tests and ROTEM (EXTEM, APTEM, FIBTEM) were performed within 30 minutes of blood sample collection.

Main Results:

• The median time from CA to hospital admission was 91 minutes.
• ROTEM assays showed severe alterations in clot formation and a high incidence of hyperfibrinolysis (83.3%).
• Prolonged CA times correlated with lower fibrinogen levels and reduced maximum clot firmness (MCF) in FIBTEM.

Conclusions:

• ROTEM analysis in cardiac arrest donors indicates severe coagulopathy.
• A high incidence of hyperfibrinolysis was observed, suggesting significant hemostatic challenges.