Observational studyWorld journal of emergency surgery : WJES2023
Guided blood transfusion of trauma patients with rotational thromboelastometry: a single-center cohort study.
Observational study in World journal of emergency surgery : WJES, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 8 papers.
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Who cites it
8 citing papers in PubMed.
- Comparison of two viscoelastic devices in patients with severe trauma: a prospective observational study.Scientific reports · 2026Observational
- Characterizing the impact of traumatic brain injury phenotype on coagulation dynamics in severely injured patients.Thrombosis research · 2026Article
- Adherence to local rotational thromboelastometry recommendations in the care of trauma patients: A retrospective cohort study.Transfusion · 2025Article
- The influence of rotational thromboelastometry (ROTEM) on operating room and intensive care transfusion practices in major trauma bleeding: a prospective cohort study with historical control.Perioperative medicine (London, England) · 2025Article
- Comparative Assessment of Thromboelastography and Rotational Thromboelastometry in Trauma-Related Coagulopathy.Cureus · 2025Article
- DYSREGULATED CLOT MECHANICS AND KINETICS IMPACTED BY INJURY SEVERITY, PREDICT MORTALITY AFTER TRAUMA.Shock (Augusta, Ga.) · 2025Article
- Blood Transfusion for Major Trauma in Emergency Department.Diagnostics (Basel, Switzerland) · 2024Review
- Anesthetic managements, morbidities and mortalities in retroperitoneal sarcoma patients experiencing perioperative massive blood transfusion.Frontiers in oncology · 2024Article
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Authors and funding
6 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundRotational thromboelastometry (ROTEM) is a blood test used to measure in vitro clot strength as a surrogate for a patient's ability to form clots in vivo. This provides information about induction, formation, and clot lysis, allowing goal-directed transfusion therapy for specific hemostatic needs. We sought to evaluate the effect of ROTEM-guided transfusion on blood product usage and in-hospital mortality among patients with a traumatic injury.
methodsThis was a single-center observational cohort analysis of emergency department patients in a Level 1 trauma center. We compared blood usage in trauma patients in whom ratio-based massive hemorrhage protocols were activated in the twelve months before the introduction of ROTEM (pre-ROTEM group) to the twelve months following the introduction of ROTEM (ROTEM-period group). ROTEM was implemented in this center in November 2016. The ROTEM device allowed clinicians to make real-time decisions about blood product therapy in resuscitation for trauma.
resultsThe pre-ROTEM group contained 21 patients. Forty-three patients were included from the ROTEM-period, of whom 35 patients received ROTEM-guided resuscitation (81% compliance). The use of fibrinogen concentrate was significantly higher in the ROTEM-period group (pre-ROTEM mean 0.2 vs. ROTEM-period mean 0.8; p = 0.006). There was no significant difference in the number of units of red blood cells, platelets, cryoprecipitate, or fresh frozen plasma transfused between these groups. There was no significant difference in the mortality rate between the pre-ROTEM and ROTEM-period groups (33% vs. 19%; p = 0.22).
conclusionsThe introduction of ROTEM-guided transfusion at this institution was associated with increased fibrinogen usage, but this did not impact mortality rates. There was no difference in the administration of red blood cell, fresh frozen plasma, platelet, and cryoprecipitate. Future research should focus on increased ROTEM compliance and optimizing ROTEM-guided transfusion to prevent blood product overuse among trauma patients.
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