Thrombelastography Today: Practicability and Analytical Power

Publisher： Karger

E-ISSN： 1660-3818|34|6|421-428

ISSN： 1660-3796

Source： Transfusion Medicine and Hemotherapy, Vol.34, Iss.6, 2007-11, pp. : 421-428

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Abstract

Today, rotational thrombelastography as a further developmentof the classical thrombelastography is increasinglyapplied to assess haemostasis and to predict complicationsof coagulation. Due to the improved robustnessof the method, RoTEMrem; analyses are now also performedoutside specialised coagulation laboratories andapplied in emergency settings. Since coagulation testing,particularly when performed with different activators, isvery sensitive to artifacts due to variations in the proportionto anticoagulants, temperature and concentration ofactivators, meticulous quality control is indispensable.For this reason, the German Federal Chamber of Physicianshas issued rigorous validity ranges for the classiccoagulation tests, such as the prothrombin time (PT/INR)or the activated partial thromboplastin time (aPTT) forvariation coefficient acceptance, which are audited 4times a year by external quality control circles. At present,no comparable quality assurance setup exists forwhole blood coagulation testing. Thus, knowledge of theanalytical limits, restrictions and caveats of this methodis central for critical interpretation of the results and reliableclinical application. This review gives an outline ofthe practicability and accuracy of the RoTEM methodologyand illustrates some pitfalls for the use in detectingand predicting disturbances of haemostasis in a casereport.