Abstract:
At the turn of the century, a significant advance in the rapidly
expanding field of rotational thrombelastography (ROTEG),
known at present as thrombelastometry or ROTEM analysis,
was developed at the Ludwig-Maximillian University in Munich.
The measuring unit is operated by a laptop computer. There
are four temperature-controlled measuring channels in which
the global assays not only detect coagulation factor defects
but also platelet function, abnormal fibrinogen polymerisation,
anticoagulant defects and hyperfibrinolysis.
ROTEM has steadily increased in popularity, particularly
because of its well-established application as a diagnostic
aid at the point of care in the critical care situation. It also
provides a useful guide in the choice of an appropriate
therapeutic option in the bleeding patient, reducing costs by
avoiding administration of costly component therapy such as
fresh-frozen plasma, cryoprecipitate, platelet concentrates or
antifibrinolytic agents.
As well as being useful in monitoring anticoagulant therapy
and the use of pharmacological agents, ROTEM is a valuable
research tool in the field of hypercoagulability, fibrinolysis, factor
XIII activity and the ultimate phases of the blood coagulation
process.
