Performance characteristics of thromboelastometry assays using incompletely filled and prolonged stored samples

Area of Science:

• Clinical diagnostics
• Hemostasis and thrombosis
• Transfusion medicine

Background:

• Thromboelastometry (TEM) is crucial for guiding transfusion therapy in patients with severe bleeding.
• Investigating the impact of sample filling volume and storage conditions on TEM accuracy is essential for reliable clinical application.

Purpose of the Study:

• To evaluate the effect of incompletely filled samples on Thromboelastometry (TEM) results.
• To assess the impact of prolonged cold storage (4°C) on TEM parameters.

Main Methods:

• Whole blood samples from healthy donors were diluted to achieve varying blood:citrate ratios (90:10 to 40:60).
• Samples were tested using EXTEM, INTEM, and FIBTEM assays on ROTEM delta machines.
• Additionally, samples stored at 4°C for 16-20 hours were retested.

Main Results:

• Samples with 90:10 and 80:20 dilutions (fully and half-filled) showed ROTEM parameters within reference ranges.
• Samples with 70:30 to 40:60 dilutions (less than half-filled) produced abnormal TEM results.
• TEM results for fully filled samples stored at 4°C for 16-20 hours remained within reference intervals.

Conclusions:

• Thromboelastometry (TEM) provides normal results for completely filled and half-filled samples.
• Prolonged cold storage (4°C) of fully filled samples does not significantly affect TEM results.
• Samples less than half-filled should not be used for Thromboelastometry (TEM) testing due to unreliable results.