ROTEM delta

"Low concentrations of rFVIIa (0.5-1 μg/mL) corrected the effects of abelacimab as assessed by rotational thromboelastometry. Our data support using low doses of rFVIIa for bleeding management in patients treated with abelacimab."

"ROTEM delta parameters on the 3rd day of fever predicted progression, whereas CCTs did not. These parameters were generated in approximately 10 minutes, at the point of care. It would be prudent to substantiate these findings in a larger study. The subclinical coagulopathy evidenced by derangements in ROTEM delta with normal Clauss and platelet greater than one hundred times ten to the power of nine per litre raises the possibility of platelet dysfunction being the cause."

"CCTs, especially INR proved to be a more reliable predictor of mortality compared to VHAs in trauma patients. These findings suggest that CCTs offer better prognostic value, although integrating both testing modalities could potentially enhance overall assessment and management strategies in trauma care."

"In pregnant patients presenting to the ED with vaginal bleeding before 20 weeks, ROTEM differences were not different in comparison to healthy pregnant patients at the same gestation stage. This suggests that ROTEM clotting profiles may not be useful in the evaluation of vaginal bleeding within this population."

"Elevated vWF antigen levels with abnormal ROTEM data suggests that COVID induces changes in the clotting cascade. More robust research is needed to investigate these findings. Thrombolytics, MT, and antiplatelet agents should be utilized to treat COVID-related ischemic stroke based on current clinical guidelines."

"These results highlight that HES increased apparent in vitro tPA-induced fibrinolysis in case of severe COVID-19 disease. Use of this plasma volume expander may translate as a potential help against COVID-19-induced thrombosis occurrence."

"While thromboelastogram testing is gaining popularity for managing bleeding patients, clinicians should be aware of these confounding factors when making transfusion decisions based on their results."

"In this study, we describe baseline ROTEM parameters in women at high risk of PPH. The majority of patients did not have a ROTEM pattern that is suggestive of hyperfibrinolysis, for which tranexamic acid is thought to be beneficial. Based on our findings, previously established obstetric transfusion thresholds for goal-directed massive transfusion protocols are likely valid for the majority of the obstetric population regardless of the presence of comorbidities or pregnancy complications."

Viscoelastic testing (VET) has revolutionized modern coagulation management by offering rapid, real-time insights into the entire hemostatic process. By enabling precise, data-driven transfusion algorithms at the point of care, VET-guided strategies significantly improve patient blood management and clinical outcomes in high-stakes environments like trauma and cardiac surgery.

"The 2 sets of PRIs were embedded into our electronic medical record, allowing clinicians to easily interpret their patient's ROTEM results against age-verified reference ranges, enabling them to make informed transfusion decisions."

"QStat provides comparable information to the ROTEM delta and TEG 6s in trauma patients and can be useful for diagnosing TIC and guiding treatment. The Quantra's simplicity of use, ability to deploy at the POC, and rapid availability of results may provide clinicians with a faster, more convenient means to assess and manage TIC."

"The ROTEM delta and sigma devices had comparable performance [with ROTEM sigma]. A negative bias was observed in the FIBTEM assay with lower extrapolated clinical decision points for a delta-guided treatment algorithm for the FIBTEM and EXTEM A5."

"Modern hemostatic management and perioperative antiplatelet therapy (APT) administration/discontinuation management should be guided by thromboelastometry and platelet function testing. Prospective interventional trials are necessary to validate such an approach in multicentric studies."

"Upregulated thrombin generation parameters after PCC spiking were not displayed by CT, ACT [ROTEM® Delta, ClotPro®, TEG®6s, and Quantra®], or standard tests. Our results do not support treatment algorithms using prolonged CT or ACT as a trigger for administration of PCC to augment thrombin generation."

Comparison of ROTEM® Delta and ROTEM® Sigma transfusion algorithm performance in thoracic aortic surgery: a single-centre prospective observational cohort study.

"The present study revealed acceptable agreement between four different assays measuring functional fibrinogen, with current- and previous-generation ROTEM® machines (Sigma, Delta) performing similarly measuring functional fibrinogen via FIBTEM assay. This suggests that haemostatic resuscitation algorithms designed for the ROTEM® Delta can be applied to the ROTEM® Sigma to guide fibrinogen replacement."

"In the obstetric setting, the ROTEM® and ClotPro® parameters demonstrate a significant variability. Device- and indication-specific transfusion algorithms are essential for the accurate interpretation of measurements and adequate hemostatic therapy."

This study confirms that the Quantra System with the QStat Cartridge is a highly reliable alternative to the ROTEM delta for monitoring hemostasis during liver transplantation. Showing strong correlation and over 90% agreement in detecting fibrinolysis, the Quantra provides comparable clinical data through a faster, more user-friendly interface. Its point-of-care efficiency makes it a valuable tool for optimizing transfusion management in critical surgical settings.

While Flores et al. demonstrate that the Quantra system strongly correlates with ROTEM, it remains to be seen if it can truly master the "intraoperative phenotype" of liver transplantation. Current viscoelastic tests often struggle to account for the complex physiological shifts caused by portal hypertension, surgical clamping, and the high coagulopathy risks specific to DCD grafts. To prove its unique value beyond existing tools, the Quantra must show a superior ability to guide clinical outcomes and manage non-surgical bleeding across all graft types.

This study demonstrates that ROTEM clotting time (CT) correlates significantly with edoxaban plasma concentrations, particularly during the first six hours post-ingestion. While the drug's effects peak between two and four hours and largely diminish by eight hours, the ExTEM and FibTEM CT parameters prove to be effective indicators of its activity. Consequently, ROTEM serves as a valuable, rapid, and on-site tool for assessing the anticoagulant effect of edoxaban in clinical settings.

This study demonstrates that ROTEM® thromboelastometry is a reliable screening tool for assessing rivaroxaban plasma concentrations. By showing a strong correlation with the HPLC-MS/MS gold standard, particularly regarding clotting time (CT), the method provides high sensitivity and specificity in monitoring anticoagulant effects. Consequently, ROTEM offers significant potential for evaluating bleeding risks and drug activity in clinical practice across various dosing regimens.