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Cited by 335Trauma, Hemostasis, Coagulopathy, ResuscitationBlood transfusion and managementHemostasis and retained surgical items

Comparison of thromboelastometry (ROTEM®) with standard plasmatic coagulation testing in paediatric surgery

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Haas, T., Spielmann, N., Mauch, J., Madjdpour, C., Speer, O., Schmugge, M., Weiss, M.·2012·British Journal of Anaesthesia
DOI 10.1093/bja/aer342
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Abstract

Background Thromboelastometry (ROTEM(®)) might be useful to detect intraoperative coagulation disorders early in major paediatric surgery. This observational trial compares this technique to standard coagulation tests. Methods Intraoperative blood sampling was obtained in children undergoing elective major surgery. At each time point, standard coagulation tests [activated partial thromboplastin time (aPTT), prothrombin time (PT), and fibrinogen level] and ROTEM(®) analyses (InTEM, ExTEM, and FibTEM) were performed simultaneously by trained hospital laboratory staff. Results A total of 288 blood samples from 50 subjects were analysed. While there was a poor correlation between PT and aPTT to ExTEM clotting time (CT) and InTEM CT, respectively, a good correlation was detected between PT and aPTT to clot formation time, and a very good correlation between fibrinogen level and FibTEM assay (r=0.882, P<0.001). Notably, 64% of PT and 94% of aPTT measurements were outside the reference range, while impaired CT was observed in 13% and 6.3%, respectively. Standard coagulation test results were available after a median of 53 min [inter-quartile range (IQR): 45-63 min], whereas 10 min values of ROTEM(®) results were available online after 23 min (IQR: 21-24 min). Conclusions PT and aPTT cannot be interchangeably used with ROTEM(®) CT. Based on the results of ROTEM(®), recommended thresholds for PT and aPTT might overestimate the need for coagulation therapy. A good correlation was found between the fibrinogen level and the FibTEM assay. In addition, ROTEM(®) offered faster turnaround times.

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Authors
Haas, T., Spielmann, N., Mauch, J., Madjdpour, C., Speer, O., Schmugge, M., & Weiss, M.
Affiliations
  • University Children's Hospital Zurich (CH)
  • University of Zurich (CH)
Corresponding author
Haas, T.
ORCID
Venue
British Journal of Anaesthesia
Publisher
Elsevier BV
Published
2012-01
Volume
108
Issue
1
Pages
36-41
ISSN
0007-0912 (ISSN-L)
DOI
10.1093/bja/aer342
OpenAlex
W2159571378
Cited by
335
References
0
Citations by year
2026: 10 · 2025: 13 · 2024: 8 · 2023: 12 · 2022: 13 · 2021: 18 · 2020: 20 · 2019: 90 · 2018: 26 · 2017: 23 · 2016: 15 · 2015: 26 · 2014: 25 · 2013: 22 · 2012: 12
FWCI
15.36
Type
journal article
Language
en
Open access
Licence
Locations
  • British Journal of Anaesthesia (publishedVersion)
  • PubMed (publishedVersion)
  • Zurich Open Repository and Archive (University of Zurich) (acceptedVersion, other-oa)
  • Zurich Open Repository and Archive (University of Zurich) (submittedVersion, other-oa)
  • Zurich Open Repository and Archive (University of Zurich)
Funders
departmental funds
Topics
  • Health Sciences › Medicine › Critical Care and Intensive Care Medicine › Trauma, Hemostasis, Coagulopathy, Resuscitation
  • Health Sciences › Medicine › Biochemistry › Blood transfusion and management
  • Health Sciences › Medicine › Hematology › Hemostasis and retained surgical items
Keywords
thromboelastometry, rotational thromboelastometry, pediatric surgery, activated partial thromboplastin time, prothrombin time, fibrinogen, coagulation tests, clot formation time, turnaround time
MeSH terms
Blood Coagulation Tests, Child, Child, Preschool, Data Interpretation, Statistical, Female, Fibrinogen, Hospitals, Pediatric, Humans, Infant, Male, Partial Thromboplastin Time, Pediatrics, Prospective Studies, Prothrombin Time, Quality Control, Reference Standards, Surgical Procedures, Operative, Thrombelastography, Guidelines as Topic

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