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Leveraging Turbidity and Thromboelastography for Complementary Clot Characterization
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The role of rotational thromboelastometry during the COVID-19 pandemic: a narrative review

Klaus Görlinger1,2, Hawra Almutawah3, Fatimah Almutawaa3

  • 1Department of Anesthesiology and Intensive Care Medicine, University Hospital Essen, University Duisburg-Essen, Essen, Germany.

Korean Journal of Anesthesiology
|January 13, 2021
PubMed

Insights

Rotational thromboelastometry (ROTEM®) aids in detecting COVID-19 coagulopathy, offering a comprehensive view beyond standard tests. Combining ROTEM® with standard coagulation tests improves patient monitoring and treatment guidance for better outcomes.

Area of Science:

  • Hematology
  • Infectious Diseases
  • Critical Care Medicine

Background:

  • COVID-19 is a global health crisis linked to hypercoagulability and fatal thromboembolic events.
  • Standard coagulation tests (SCT) often fail to detect COVID-19-associated hypercoagulability.
  • Viscoelastic tests like ROTEM® offer a more comprehensive assessment of coagulation status.

Purpose of the Study:

  • To review the role of rotational thromboelastometry (ROTEM®) in managing COVID-19-associated coagulopathy.
  • To explore how ROTEM® parameters can characterize coagulation abnormalities in COVID-19 patients.
  • To assess the utility of ROTEM® in guiding anticoagulant therapy and improving patient outcomes.

Main Methods:

  • Review of published literature on ROTEM® and COVID-19 coagulopathy.
  • Analysis of ROTEM® parameters in relation to hypercoagulability and hypocoagulability.
  • Comparison of ROTEM® with standard coagulation tests (SCT) for COVID-19 patients.

Main Results:

  • COVID-19 coagulopathy, assessed by ROTEM®, can range from hypercoagulability to hypocoagulability.
  • ROTEM® provides detailed information on individual coagulation status and dynamic changes.
  • Combining ROTEM® with SCT (e.g., fibrinogen, D-dimer) aids in detecting hemostasis issues.

Conclusions:

  • A multimodal diagnostic approach using ROTEM® and SCT is recommended for COVID-19 patients.
  • ROTEM® aids in guiding anticoagulant therapy and potentially improving outcomes.
  • Further research is needed to establish evidence-based guidelines for ROTEM® use in COVID-19.

Keywords:
AnticoagulantsBlood coagulation disordersCOVID-19FibrinolysisSARSCoV-2ThrombelastographyThrombophilia

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