Document Detail


Temporal changes in ROTEM(®)-measured coagulability of citrated blood samples from coagulopathic trauma patients.
MedLine Citation:
PMID:  22204772     Owner:  NLM     Status:  Publisher    
Abstract/OtherAbstract:
BACKGROUND: Rotational thromboelastometry (ROTEM(®)) relies on citrated blood samples, which are regarded as biologically stable for up to 4h after venepuncture. However, this recommendation is based on data from normal volunteers. The aim of this study was to evaluate possible temporal changes in the coagulability of blood samples from coagulopathic trauma patients. PATIENTS AND METHODS: This is a prospective series of 10 coagulopathic (maximum clot firmness, MCF<40mm) trauma patients. ROTEM(®) EXTEM (tissue factor activated) and FIBTEM (tissue factor activated, cytochalasin D inhibited) analyses were performed on samples obtained on admission, and after approximately 60min of storage in an incubator, at 37°C. RESULTS: There were statistically significant differences between the median EXTEM MCF (22mm vs 54mm, p<0.001) and α angle (30.5 vs 59.5°, p=0.004) of the analyses performed immediately after sampling, and 51min (median) subsequently, but not coagulation time (CT, p=0.133), clot formation time (p=0.0625) or maximum lysis (ML, p=0.154). There were also no differences in median FIBTEM MCF (p=1.00) or CT (p=0.877) between the immediate and delayed analyses. CONCLUSIONS: Repeated ROTEM(®) EXTEM analysis of citrated samples from coagulopathic trauma patients shows a spontaneous improvement in coagulability with time. The absence of parallel changes on FIBTEM analysis suggests that this effect may be due to a change in platelet function.
Authors:
J O Jansen; D Luke; E Davies; P Spencer; E Kirkman; M J Midwinter
Publication Detail:
Type:  JOURNAL ARTICLE     Date:  2011-12-26
Journal Detail:
Title:  Injury     Volume:  -     ISSN:  1879-0267     ISO Abbreviation:  -     Publication Date:  2011 Dec 
Date Detail:
Created Date:  2011-12-29     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  0226040     Medline TA:  Injury     Country:  -    
Other Details:
Languages:  ENG     Pagination:  -     Citation Subset:  -    
Copyright Information:
Copyright © 2011. Published by Elsevier Ltd.
Affiliation:
Royal Army Medical Corps, United Kingdom.
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