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Modified Rotational Thromboelastometry Protocol Using Tissue Plasminogen Activator for Detection of Hypofibrinolysis
Julie Brogaard Larsen1,2, Christine Lodberg Hvas3,4, Anne-Mette Hvas3
1Department of Clinical Biochemistry, Aarhus University Hospital, Aarhus, Denmark. jullarse@rm.dk.
Methods in Molecular Biology (Clifton, N.J.)
|May 19, 2023
Summary
Standard viscoelastic tests like ROTEM® have limited ability to assess fibrinolysis. A modified ROTEM® protocol with tissue plasminogen activator can now identify hypofibrinolysis and hyperfibrinolysis in bleeding patients.
Area of Science:
- Hematology
- Clinical Pathology
Background:
- Viscoelastic testing, including thromboelastography (TEG®) and thromboelastometry (ROTEM®), is crucial for managing bleeding patients.
- Standard tests primarily assess clot formation and guide transfusion but have limitations in evaluating fibrinolysis.
Purpose of the Study:
- To describe a modified ROTEM® protocol for assessing fibrinolytic capacity.
- To enable identification of both hypofibrinolysis and hyperfibrinolysis.
Main Methods:
- A modified ROTEM® assay incorporating tissue plasminogen activator was developed.
- This protocol was used to evaluate fibrinolytic function in patients.
Main Results:
- The modified ROTEM® protocol allows for the assessment of fibrinolytic activity.
- It can differentiate between conditions of excessive or insufficient fibrinolysis.
Conclusions:
- A modified ROTEM® assay provides a valuable tool for assessing fibrinolysis.
- This method can guide more precise therapeutic interventions in bleeding disorders.
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