Observational studyEmergency medicine Australasia : EMA2022
Rotational thromboelastometry in children presenting to an Australian major trauma centre: A retrospective cohort study.
Observational study in Emergency medicine Australasia : EMA, 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 4 papers.
What it found
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
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Who cites it
4 citing papers in PubMed, 5 citations in OpenAlex.
- Critical trigger thresholds for hemostatic management: a narrative review of viscoelastic hemostatic assay applications.Frontiers in medicine · 2025Review
- Polytrauma in Children—Epidemiology, Acute Diagnostic Evaluation, and Treatment.Deutsches Arzteblatt international · 2024Review
- Fibrinogen Early In Severe paediatric Trauma studY (FEISTY junior): protocol for a randomised controlled trial.BMJ open · 2022Article
- Rotational thromboelastometry and patient blood management: A narrative review.Asian journal of transfusion scienceReview
Corrections and comments
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Authors and funding
5 authors at 1 institution in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
objectiveThis retrospective cohort study aims to describe patterns of rotational thromboelastometry (ROTEM™) results in paediatric trauma following the implementation of a ROTEM-guided critical bleeding algorithm and major haemorrhage protocol (MHP).
methodsThis retrospective observational study was conducted in a tertiary trauma hospital in Queensland, Australia, where point-of-care ROTEM was introduced for paediatric patients in 2014. All children aged less than 18 years who had a ROTEM test during their presentation between January 2014 and December 2017 for a traumatic injury were included in the dataset. Other children with a record in the hospital's trauma registry in the same period were also screened for blood product usage. Data were collected for frequency of ROTEM testing, pathology and ROTEM results, blood product and antifibrinolytic use along with injury related data. Compliance with recommended treatment thresholds for detected coagulopathy was also reviewed.
resultsA total of 1039 children were listed in the trauma registry, including 167 children having a ROTEM test for trauma. Factors significantly associated with having a ROTEM test were older age, higher injury severity score (ISS >12) and penetrating injury. A result exceeding a treatment threshold was returned for 122 (73.1%) of 167 children, with hyperfibrinolysis identified in 88 (52.6%) of 167 and hypofibrinogenaemia identified in 54 (32.3%) of 167. Adherence with the recommended treatments for those children where a treatment threshold was exceeded was low in this cohort.
conclusionThe use of ROTEM-guided blood component replacement is an emerging practice in children for both traumatic and non-traumatic bleeding. Targeted replacement of identified coagulation defects guided by rapid point-of-care testing is an emerging alternative to fixed-ratio-based protocols. Further research is required to validate treatment thresholds in the paediatric population and further investigate the clinical outcomes for patients as a result of early correction of trauma-induced coagulopathy.
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