Observational studyJournal of thrombosis and haemostasis : JTH2019
Towards patient-specific management of trauma hemorrhage: the effect of resuscitation therapy on parameters of thromboelastometry.
Observational study in Journal of thrombosis and haemostasis : JTH, 2019. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 16 papers, 1 of them a synthesis that pooled it.
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Who cites it
16 citing papers in PubMed, 1 synthesis or guideline pooled it, 43 citations in OpenAlex.
- Inhospital coagulation management and fluid replacement therapy in patients with multiple and/or severe injuries - a systematic review and clinical practice guideline update.European journal of trauma and emergency surgery : official publication of the European Trauma Society · 2025Pooled it
- Blood product supplementation modulates clotting kinetics, mechanics, and fibrin architecture in an in vitro model of trauma-induced coagulopathy.Thrombosis research · 2026Article
- Viscoelastic Hemostatic Assays in the Management of Trauma-Induced Coagulopathy: A Clinical Update.Journal of clinical medicine · 2025Review
- Visco-elastic testing in traumatic bleeding.Intensive care medicine · 2024Article
- Quick model-based viscoelastic clot strength predictions from blood protein concentrations for cybermedical coagulation control.Nature communications · 2024Article
- Shock-Driven Endotheliopathy in Trauma Patients Is Associated with Leucocyte Derived Extracellular Vesicles.International journal of molecular sciences · 2022Observational
- Variations and obstacles in the use of coagulation factor concentrates for major trauma bleeding across Europe: outcomes from a European expert meeting.European journal of trauma and emergency surgery : official publication of the European Trauma Society · 2022Review
- Personalized modulation of coagulation factors using a thrombin dynamics model to treat trauma-induced coagulopathy.NPJ systems biology and applications · 2021Article
- Bosutinib reduces endothelial permeability and organ failure in a rat polytrauma transfusion model.British journal of anaesthesia · 2021Article
- Fibrinogen Early In Severe Trauma studY (FEISTY): results from an Australian multicentre randomised controlled pilot trial.Critical care and resuscitation : journal of the Australasian Academy of Critical Care Medicine · 2021Article
- The European Perspective on the Management of Acute Major Hemorrhage and Coagulopathy after Trauma: Summary of the 2019 Updated European Guideline.Journal of clinical medicine · 2021Article
- "TEG talk": expanding clinical roles for thromboelastography and rotational thromboelastometry.Hematology. American Society of Hematology. Education Program · 2020Article
- A comparison between the TEG 6s and TEG 5000 analyzers to assess coagulation in trauma patients.The journal of trauma and acute care surgery · 2020Observational
- Pre-hospital plasma transfusion: a valuable coagulation support or an expensive fluid therapy?Critical care (London, England) · 2019Article
- Towards patient-specific management of trauma hemorrhage: the effect of resuscitation therapy on parameters of thromboelastometry.Journal of thrombosis and haemostasis : JTH · 2019Observational
- Tailoring transfusion strategy using thromboelastogram in goal-directed massive transfusion: Impact on transfusion requirements and clinical outcomes.Asian journal of transfusion scienceArticle
Corrections and comments
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Authors and funding
14 authors at 7 institutions in 5 countries.
Funding
No grant is acknowledged in the PubMed record.
Abstract
Essentials The response of thromboelastometry (ROTEM) parameters to therapy is unknown. We prospectively recruited hemorrhaging trauma patients in six level-1 trauma centres in Europe. Blood products and pro-coagulants prevent further derangement of ROTEM results. ROTEM algorithms can be used to treat and monitor trauma induced coagulopathy. SUMMARY: Background Rotational thromboelastometry (ROTEM) can detect trauma-induced coagulopathy (TIC) and is used in transfusion algorithms. The response of ROTEM to transfusion therapy is unknown. Objectives To determine the response of ROTEM profiles to therapy in bleeding trauma patients. Patients/Methods A prospective multicenter study in bleeding trauma patients (receiving ≥ 4 red blood cell [RBC] units) was performed. Blood was drawn in the emergency department, after administration of 4, 8 and 12 RBC units and 24 h post-injury. The response of ROTEM to plasma, platelets (PLTs), tranexamic acid (TXA) and fibrinogen products was evaluated in the whole cohort as well as in the subgroup of patients with ROTEM values indicative of TIC. Results Three hundred and nine bleeding and shocked patients were included. A mean dose of 3.8 g of fibrinogen increased FIBTEM CA5 by 5.2 mm (IQR: 4.1-6.3 mm). TXA administration decreased lysis by 5.4% (4.3-6.5%). PLT transfusion prevented further derangement of parameters of clot formation. The effect of PLTs on EXTEM ca5 values was more pronounced in patients with a ROTEM value indicative of TIC than in the whole cohort. Plasma transfusion decreased EXTEM clotting time by 3.1 s (- 10 s to 3.9 s) in the whole cohort and by 10.6 s (- 45 s to 24 s) in the subgroup of patients with a ROTEM value indicative of TIC. Conclusion The effects of therapy on ROTEM values were small, but prevented further derangement of test results. In patients with ROTEM values indicative of TIC, the efficacy of PLTs and plasma in correcting deranged ROTEM parameters is possibly more robust.
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