Skip to main content
Key Specialties
Cardiology Diabetology Endocrinology Gastroenterology Geriatrics and Gerontology Gynecology and Obstetrics Hematology Infectious Disease Internal Medicine Nephrology Neurology Oncology Pediatrics Respiratory Medicine Rheumatology Surgery
Congress Coverage
2024 ACC Congress 2023 ESMO Congress 2023 EASD Congress 2023 ERS Congress 2023 ESC Congress 2023 EHA Congress 2023 ASCO Annual Meeting
Clinical Collections
Advances in Alzheimer’s

Keynote webinar | Spotlight on sleep in brain health

LIVE: Thursday 2nd May 2024, 18:00-19:30 (CEST)

Quality sleep is essential for health. But what happens to our brains when sleep patterns are disturbed? Join our experts to explore the interplay between sleep disruption and neurological diseases, and the questions that you need to be asking your patients to help you prevent the harmful effects of sleep deprivation.
ADVANCED SEARCH
Log in
Top
Critical Care
Published in: Critical Care 6/2014

Open Access 01-12-2014 | Commentary

TEG®- or ROTEM®-based individualized goal-directed coagulation algorithms: don’t wait - act now!

Author: Donat R Spahn

Published in: Critical Care | Issue 6/2014

Login to get access

Abstract

In trauma patients, TEG® and ROTEM® allow prediction of massive transfusion requirement and mortality, and creation of goal-directed, individualized coagulation algorithms that may improve patient outcome. This outcome benefit has been shown for cardiac surgery in prospective randomized trials. For trauma, only non-randomized studies have been performed. Nevertheless, TEG® and ROTEM® are highly promising monitoring techniques to guide coagulation management in all types of major bleeding, including trauma.
Literature
1.
Da Luz LT, Nascimento B, Shankarakutty AK, Rizoli S, Adhikari NKJ: Effect of thromboelastography (TEG®) and rotational thromboelastometry (ROTEM®) on diagnosis of coagulopathy, transfusion guidance and mortality in trauma: descriptive systematic review. Crit Care. 2014, 18: 518-10.1186/s13054-014-0518-9.PubMedCentralCrossRef
2.
Weber CF, Gorlinger K, Meininger D, Herrmann E, Bingold T, Moritz A, Cohn LH, Zacharowski K: Point-of-care testing: a prospective, randomized clinical trial of efficacy in coagulopathic cardiac surgery patients. Anesthesiology. 2012, 117: 531-547. 10.1097/ALN.0b013e318264c644.CrossRef
3.
Rahe-Meyer N, Solomon C, Hanke A, Schmidt DS, Knoerzer D, Hochleitner G, Sorensen B, Hagl C, Pichlmaier M: Effects of fibrinogen concentrate as first-line therapy during major aortic replacement surgery: a randomized, placebo-controlled trial. Anesthesiology. 2013, 118: 40-50. 10.1097/ALN.0b013e3182715d4d.CrossRef
4.
Spahn DR, Bouillon B, Cerny V, Coats TJ, Duranteau J, Fernandez-Mondejar E, Filipescu D, Hunt BJ, Komadina R, Nardi G, Neugebauer E, Ozier Y, Riddez L, Schultz A, Vincent JL, Rossaint R: Management of bleeding and coagulopathy following major trauma: an updated European guideline. Crit Care. 2013, 17: R76-10.1186/cc12685.PubMedCentralCrossRef
5.
Schochl H, Nienaber U, Maegele M, Hochleitner G, Primavesi F, Steitz B, Arndt C, Hanke A, Voelckel W, Solomon C: Transfusion in trauma: thromboelastometry-guided coagulation factor concentrate-based therapy versus standard fresh frozen plasma-based therapy. Crit Care. 2011, 15: R83-10.1186/cc10078.PubMedCentralCrossRef
6.
Schoechl H, Nienaber U, Hofer G, Voelckel W, Jambor C, Scharbert G, Kozek-Langenecker S, Solomon C: Goal-directed coagulation management of major trauma patients using rotation thromboelastometry (ROTEM)-guided administration of fibrinogen and prothrombin complex concentrate. Crit Care. 2010, 14: R55-10.1186/cc8948.CrossRef
7.
Theusinger OM, Nurnberg J, Asmis LM, Seifert B, Spahn DR: Rotation thromboelastometry (ROTEM) stability and reproducibility over time. Eur J Cardiothorac Surg. 2010, 37: 677-683. 10.1016/j.ejcts.2009.07.038.CrossRef
8.
Chapman MP, Moore EE, Ramos CR, Ghasabyan A, Harr JN, Chin TL, Stringham JR, Sauaia A, Silliman CC, Banerjee A: Fibrinolysis greater than 3% is the critical value for initiation of antifibrinolytic therapy. J Trauma Acute Care Surg. 2013, 75: 961-967. 10.1097/TA.0b013e3182aa9c9f. discussion 967PubMedCentralCrossRef
9.
Nascimento B, Callum J, Tien H, Rubenfeld G, Pinto R, Lin Y, Rizoli S: Effect of a fixed-ratio (1:1:1) transfusion protocol versus laboratory-results-guided transfusion in patients with severe trauma: a randomized feasibility trial. CMAJ. 2013, 185: E583-E589. 10.1503/cmaj.121986.PubMedCentralCrossRef
Metadata
Title
TEG®- or ROTEM®-based individualized goal-directed coagulation algorithms: don’t wait - act now!
Author
Donat R Spahn
Publication date
01-12-2014
Publisher
BioMed Central
Published in
Critical Care / Issue 6/2014
Electronic ISSN: 1364-8535
DOI
https://doi.org/10.1186/s13054-014-0637-3

Other articles of this Issue 6/2014

Critical Care 6/2014 Go to the issue

Research

Decreasing the time to achieve therapeutic vancomycin concentrations in critically ill patients: developing and testing of a dosing nomogram

Letter

Pathological changes in a patient with acute respiratory distress syndrome and H7N9 influenza virus infection

Research

Vitamin D deficiency as a risk factor for infection, sepsis and mortality in the critically ill: systematic review and meta-analysis

Research

Proton pump inhibitors increase the risk for hospital-acquired Clostridium difficile infection in critically ill patients

Research

Dynamic arterial elastance as a predictor of arterial pressure response to fluid administration: a validation study

Research

Mechanism of action of tranexamic acid in bleeding trauma patients: an exploratory analysis of data from the CRASH-2 trial