Anest. intenziv. Med. 2016;27(4):259-266

Rotational thromboelastometry (ROTEM) in the management of perioperative haemorrhagePostgraduate education

M. Durila

Klinika anesteziologie, resuscitace a intenzivní medicíny, 2. LF UK a FN Motol, Praha

Rotational thromboelastometry (ROTEM) is currently increasingly used in the management of perioperative bleeding. As a bed-side test it replaces conventional coagulation tests in this situation and allows to provide targeted treatment of the coagulopathy, leading to reduced bleeding and reduced administration of transfusion products.
This article describes in a simple way the principle of the method, the investigated parameters, specific tests, the issue of the temperature setting and the limitations of the method. It provides an overview of the normal ranges of parameters for different age groups and for pregnant women, and explains the steps and scheme of the management of acute bleeding. In conclusion, we describe a case of traumatic bleeding managed by ROTEM, where we point out that the administration of fresh frozen plasma for the treatment of severe traumatic coagulopathy did not lead to satisfactory correction of coagulopathy and had to be accompanied by administration of other clotting factors such as fibrinogen and prothrombin complex factors.

Keywords: management; bleeding; ROTEM; thromboelastometry

Received: April 28, 2016; Accepted: May 10, 2016; Published: August 1, 2016  Show citation