Utility of interim ROTEM® values of clot strength, A5 and A10, in predicting final assessment of coagulation status in severely injured battle patients

Woolley, Tom; Midwinter, Mark J.; Spencer, Phillippa; Watts, Sarah; Doran, Catherine; Kirkman, Emrys

doi:10.1016/j.injury.2012.03.018

Cited by 56 publications

(47 citation statements)

References 22 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…7, 16 We investigated the correlation between the early amplitudes, A5 and A10, with MA/ MCF and found a moderate-to-strong correlations for all assays examined with, as expected, the strongest correlation for A10 as compared with A5. 32 In the TEG assays, MRTG had the greatest correlation with early amplitudes and least with MA, and the correlation with platelet count and fibrinogen concentration was strongest at A10 as compared with both A5 and MA/MCF for CK, rTEG, EXTEM, and INTEM. Consequently, A10 may potentially give a more correct and earlier ''snapshot'' of hemostasis than MA/MCF, the rationale being that A10 reflects a more dynamic part of the hemostatic process rather than MA/MCF.…”

Section: Discussionmentioning

confidence: 83%

Thrombelastography and rotational thromboelastometry early amplitudes in 182 trauma patients with clinical suspicion of severe injury

Meyer

Sørensen

et al. 2014

Journal of Trauma and Acute Care Surgery

View full text Add to dashboard Cite

show abstract

Section: Discussionmentioning

confidence: 83%

Thrombelastography and rotational thromboelastometry early amplitudes in 182 trauma patients with clinical suspicion of severe injury

Meyer

Sørensen

et al. 2014

Journal of Trauma and Acute Care Surgery

View full text Add to dashboard Cite

show abstract

“…Die präanalytischen Variablen mit Einfluss auf die Testergebnisse schließen die Technik der Blutabnahme und den Gebrauch spezifischer Antikoagulanzien ein [23,44,95]. Anders als bei elektiven Blutabnahmen im Rahmen der Routinediagnostik kann es im Rahmen der unter Zeitdruck ablaufenden Schwerverletztenversorgung im Schockraum durch Scherkräfte bei der Probengewinnung und -behandlung zu einer Thrombozytenaktivierung mit daraus resultierender Veränderung der Testergebnisse kommen [44].…”

Section: Empfehlung Der Konsensusgruppeunclassified

“…Anders als bei elektiven Blutabnahmen im Rahmen der Routinediagnostik kann es im Rahmen der unter Zeitdruck ablaufenden Schwerverletztenversorgung im Schockraum durch Scherkräfte bei der Probengewinnung und -behandlung zu einer Thrombozytenaktivierung mit daraus resultierender Veränderung der Testergebnisse kommen [44]. Dieser Effekt wurde im Rahmen einer Studie durch wiederholte Messung ein und derselben Blutprobe über einen Zeitraum von 1 h nach Abnahme gezeigt [95], konnte allerdings von anderen Autoren nicht nachgewiesen werden [90]. Wird eine nichtantikoagulierte Probe zur Analyse verwendet, beeinflusst die Zeit zwischen Blutabnahme und Testbeginn die Ergebnisse deutlich [57].…”

Section: Empfehlung Der Konsensusgruppeunclassified

Frühe viskoelastizitätsbasierte Gerinnungstherapie bei blutenden Schwerverletzten

et al. 2015

View full text Add to dashboard Cite

Although there is increasing interest in the use of a viscoelastic test procedure (ROTEM/TEG) for diagnostics and therapy guidance of severely injured and bleeding patients, currently no uniformly accepted guidelines exist for how this technology should be integrated into clinical treatment. In September 2014 an international multidisciplinary group of opinion leaders in the field of trauma-induced coagulopathy and other disciplines involved in the treatment of severely injured patients were assembled for a 2-day consensus conference in Philadelphia (USA). This panel included trauma/accident surgeons, general/abdominal surgeons, vascular surgeons, emergency/intensive care surgeons, hematologists, transfusion specialists, anesthesiologists, laboratory physicians, pathobiologists/pathophysiologists and the lay public. A total of nine questions regarding the impact of viscoelastic testing in the early treatment of trauma patients were developed prior to the conference by a panel consensus. Early use was defined as baseline viscoelastic test result thresholds obtained within the first minutes of hospital arrival, when conventional laboratory results are not yet available. The available data for each question were then reviewed in person using standardized presentations by the expert panel. A consensus summary document was then developed and reviewed by the panel in an open forum. Finally, a 2-round Delphi poll was administered to the panel of experts regarding viscoelastic thresholds for triggering the initiation of specific treatments including fibrinogen (concentrates), platelet concentrates, blood plasma products and prothrombin complex concentrates (PCC). This report summarizes the findings and recommendations of this consensus conference, which correspond to a S2k guideline according to the system of the Association of the Scientific Medical Societies in Germany (AWMF) and taking formal consensus findings including Delphi methods into consideration.

show abstract

“…ROTEM was found to be a robust technique that could be applied in a busy Role 3 hospital 22. A subsequent study identified a means, using interim values reported by ROTEM, to reduce the time required to identify the presence of coagulopathy 21. A further study showed, for the first time, that coagulopathic blood, unlike normal blood, was not stable with respect to ROTEM analysis for a period of hours after collection.…”

Section: Deployed Research: Aetiology Of Trauma Coagulopathymentioning

confidence: 99%

Combat Casualty Care research programme

Kirkman

Watts

2014

J R Army Med Corps

View full text Add to dashboard Cite

The Combat Casualty Care research programme is an integrated suite of projects designed to address Defence Medical Services' research needs for casualty care. The programme covers a broad spectrum of topics ranging from the pathophysiological and immunological impact of military relevant injuries to the effects of these disturbances on the response to early treatment. Dstl Porton Down has a long history of studying military injuries and has developed models, both in vivo and physical, to address the research needs. The work is conducted in close collaboration with clinical colleagues at the Royal Centre for Defence Medicine who have direct experience of the clinical issues faced by combat casualties and insights into the potential clinical implications of emerging strategies. This article reviews progress in research areas spanning forward resuscitation, with a particular focus on blast-related injuries, trauma coagulopathy, effects of drugs on the response to haemorrhage and deployed research. A significant 'value added' component has been the underpinning of higher degrees for seconded military clinicians at Dstl Porton Down who have made a valuable contribution to the overall programme.

show abstract

Utility of interim ROTEM® values of clot strength, A5 and A10, in predicting final assessment of coagulation status in severely injured battle patients

Cited by 56 publications

References 22 publications

Thrombelastography and rotational thromboelastometry early amplitudes in 182 trauma patients with clinical suspicion of severe injury

Thrombelastography and rotational thromboelastometry early amplitudes in 182 trauma patients with clinical suspicion of severe injury

Frühe viskoelastizitätsbasierte Gerinnungstherapie bei blutenden Schwerverletzten

Combat Casualty Care research programme

Contact Info

Product

Resources

About