PMID- 22086509
OWN - NLM
STAT- MEDLINE
DCOM- 20120123
LR  - 20220331
IS  - 1471-6771 (Electronic)
IS  - 0007-0912 (Linking)
VI  - 108
IP  - 1
DP  - 2012 Jan
TI  - Comparison of thromboelastometry (ROTEM(R)) with standard plasmatic coagulation 
      testing in paediatric surgery.
PG  - 36-41
LID - 10.1093/bja/aer342 [doi]
AB  - BACKGROUND: Thromboelastometry (ROTEM((R))) 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((R)) 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((R)) results were available online after 23 min 
      (IQR: 21-24 min). CONCLUSIONS: PT and aPTT cannot be interchangeably used with 
      ROTEM((R)) CT. Based on the results of ROTEM((R)), 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((R)) 
      offered faster turnaround times.
FAU - Haas, T
AU  - Haas T
AD  - Department of Anaesthesia, University Children's Hospital Zurich, 
      Steinwiesstrasse 75, Zurich 8032, Switzerland. thorsten.haas@kispi.uzh.ch
FAU - Spielmann, N
AU  - Spielmann N
FAU - Mauch, J
AU  - Mauch J
FAU - Madjdpour, C
AU  - Madjdpour C
FAU - Speer, O
AU  - Speer O
FAU - Schmugge, M
AU  - Schmugge M
FAU - Weiss, M
AU  - Weiss M
LA  - eng
PT  - Comparative Study
PT  - Journal Article
PT  - Research Support, Non-U.S. Gov't
DEP - 20111114
PL  - England
TA  - Br J Anaesth
JT  - British journal of anaesthesia
JID - 0372541
RN  - 9001-32-5 (Fibrinogen)
SB  - IM
MH  - Blood Coagulation Tests/*methods/standards
MH  - Child
MH  - Child, Preschool
MH  - Data Interpretation, Statistical
MH  - Female
MH  - Fibrinogen/analysis
MH  - Guidelines as Topic
MH  - Hospitals, Pediatric
MH  - Humans
MH  - Infant
MH  - Male
MH  - Partial Thromboplastin Time
MH  - Pediatrics/*methods
MH  - Prospective Studies
MH  - Prothrombin Time
MH  - Quality Control
MH  - Reference Standards
MH  - Surgical Procedures, Operative/*methods
MH  - Thrombelastography/*methods/standards
EDAT- 2011/11/17 06:00
MHDA- 2012/01/24 06:00
CRDT- 2011/11/17 06:00
PHST- 2011/11/17 06:00 [entrez]
PHST- 2011/11/17 06:00 [pubmed]
PHST- 2012/01/24 06:00 [medline]
AID - S0007-0912(17)32513-8 [pii]
AID - 10.1093/bja/aer342 [doi]
PST - ppublish
SO  - Br J Anaesth. 2012 Jan;108(1):36-41. doi: 10.1093/bja/aer342. Epub 2011 Nov 14.