PDF(Pubmed)
Abstract：
Rotational thromboelastometry (ROTEM) is a viscoelastic method, which provides a graphical and numerical representation of induced hemostasis in whole blood samples. Its ability to quickly assess the state of hemostasis is used in the management of bleeding from a variety of causes. The separate activation of particular parts of hemocoagulation in INTEM, EXTEM, and FIBTEM tests allows for a more comprehensive and faster evaluation of the missing component of hemostasis followed by targeted therapy. One of the most common cause of coagulopathy is trauma-induced coagulopathy. Fibrinogen replacement therapy by ROTEM allows for the use of a standard dosage of fibrinogen, which has been shown to be successful in preventing dilutional coagulopathy following colloid and crystalloid replacement and excessive amount of allogeneic blood transfusions. The best reflection of fibrinogen activity is observed in the FIBTEM assay, where fibrinogen replacement therapy is recommended at an MCF (maximum clot firmness) of FIBTEM < 10 mm and FIBTEM A10 < 7 mm. ROTEM also plays an important role in the diagnostic and management of inherited fibrinogen disorders. These can be manifested by bleeding complications, where changes in the MCF parameter are the most useful tool for assessing the effectiveness of fibrinogen replacement therapy. ROTEM-guided bleeding management algorithms effectively reduce the number of transfusions, healthcare costs, and complications, leading to the improvement of patient safety and overall health.
摘要：
旋转血栓弹性测定法（ROTEM）是一种粘弹性方法，它提供了全血样中诱导止血的图形和数字表示。其快速评估止血状态的能力用于管理各种原因引起的出血。INTEM中血液凝固的特定部分的单独激活，EXTEM,和FIBTEM测试可以更全面，更快地评估止血缺失的成分，然后进行靶向治疗。凝血病的最常见原因之一是创伤诱发的凝血病。ROTEM的纤维蛋白原替代疗法允许使用标准剂量的纤维蛋白原，已被证明可以成功预防胶体和晶体替代以及过量的同种异体输血后的稀释性凝血病。在FIBTEM测定中观察到纤维蛋白原活性的最佳反映，在FIBTEM<10mm和FIBTEMA10<7mm的MCF(最大凝块硬度)下,推荐纤维蛋白原替代疗法。ROTEM在遗传性纤维蛋白原疾病的诊断和管理中也起着重要作用。这些可以表现为出血并发症，其中MCF参数的变化是评估纤维蛋白原替代疗法有效性的最有用工具。ROTEM引导的出血管理算法有效减少输血次数,医疗费用,和并发症，改善患者安全和整体健康状况。
