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Rotational Thromboelastometry (ROTEM®)

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Trauma Induced Coagulopathy

Abstract

Thromboelastometry (ROTEM®) is an advancement of the classical thromboelastography. Several technical enhancements made the device more robust and user-friendly, reduced intra- and inter-operator variability, and improved the diagnostic performance. This allows for using the device at the bedside in a mobile way and in a multiuser environment, even in military settings. The ROTEM® device is not only able to detect multiple aspects of trauma-induced coagulopathy (TIC) and disseminated intravascular coagulation (DIC), but it allows for prediction of bleeding, massive transfusion, thrombosis, and mortality, too. Furthermore, the ROTEM® device is designed to guide hemostatic therapy with allogeneic blood products (RBC, FFP, cryoprecipitate, and platelets) and in particular with specific coagulation factor concentrates (fibrinogen concentrate, prothrombin complex concentrate (PCC), factor XIII concentrate, and rFVIIa). Here, the combination of specific ROTEM® assays improved the diagnostic performance, significantly. Finally, the implementation of ROTEM®-guided bleeding management algorithms (“Theragnostic Approach”) has been shown to reduce transfusion requirements, complication rates, morbidity, mortality, and hospital costs in trauma and other clinical settings.

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Authors and Affiliations

  1. Department of Anesthesiology and Intensive Care Medicine, University Hospital Essen, Hufelandstrasse 55, 45122, Essen, Germany

    Klaus Görlinger M.D. & Daniel Dirkmann M.D.

  2. Tem International GmbH, Martin-Kollar-Strasse 13-15, 81829, Munich, Germany

    Klaus Görlinger M.D.

  3. Department of Anesthesiology and Intensive Care Medicine, Hannover Medical School, Carl-Neuberg-Strasse 1, 30625, Hannover, Germany

    Alexander A. Hanke M.D.

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  1. Klaus Görlinger M.D.
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  2. Daniel Dirkmann M.D.
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  3. Alexander A. Hanke M.D.
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Correspondence to Klaus Görlinger M.D. .

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Editors and Affiliations

  1. Dept of Surgery & Trauma Research Center, Univ of Colorado School of Medicine, Aurora, Colorado, USA

    Eduardo Gonzalez

  2. Dept of Surgery & Trauma Research Center, Univ of Colorado School of Medicine, Aurora, Colorado, USA

    Hunter B. Moore

  3. Dept of Surgery & Trauma Research Center, Univ of Colorado Sch of Med&Denver Healt, Denver, Colorado, USA

    Ernest E. Moore

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Görlinger, K., Dirkmann, D., Hanke, A.A. (2016). Rotational Thromboelastometry (ROTEM®). In: Gonzalez, E., Moore, H., Moore, E. (eds) Trauma Induced Coagulopathy. Springer, Cham. https://doi.org/10.1007/978-3-319-28308-1_18

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