• Medicina intensiva · Oct 2019

    Observational Study

    Rotational thromboelastometry (ROTEM) profile in a cohort of asystole donors.

    • J A Barea-Mendoza, L J Terceros-Almanza, C García-Fuentes, S Bermejo-Aznárez, I J Prieto Del Portillo, C Mudarra-Reche, M Valiente-Fernández, A Rodríguez-Biendicho, J C Montejo González, and M Chico-Fernández.
    • Grupo de Investigación en Trauma y Emergencias (GINTEM-12), Unidad de Trauma y Emergencias, Servicio de Medicina Intensiva, Hospital Universitario 12 de Octubre, Madrid, España. Electronic address: jbareamendoza@gmail.com.
    • Med Intensiva. 2019 Oct 1; 43 (7): 410-415.

    BackgroundHypoperfusion plays a central role in shock states, and has been proposed as a coagulopathy trigger. The study of the rotational thromboelastometry (ROTEM) profile during cardiac arrest could offer new insights to the role of hypoperfusion in coagulation during shock states.OutcomeTo describe the ROTEM profile in a cohort of asystole donors and elucidate the incidence of hyperfibrinolysis.DesignA prospective observational study was carried out in 18 patients consecutively admitted to the ICU after out-of-hospital non-recovered cardiac arrest (CA). Initial rhythm and time between CA and admission were recorded. Conventional coagulation and ROTEM (EXTEM, APTEM, FIBTEM) tests were performed within 30minutes after blood sample collection.ScopeAn asystole donor reference hospital.ParticipantsPatients admitted to the ICU after out-of-hospital non-recovered CA.ResultsThe median age was 50years, and 14 of the patients were men (77.8%). The time from CA to hospital admission expressed as the median (interquartile range) was 91minutes (75-104). The results of the routine tests were: INR 1.25 (1.19-1.34), aPTT 55s (45-73) and fibrinogen 161mg/dl (95-295). For the ROTEM APTEM assay the results were: CT 126s (104-191), CFT 247s (203-694). Hyperfibrinolysis criteria were recorded in 15 patients (83.3%). In addition, MCF improved in APTEM versus EXTEM. Prolonged CA times were associated to lower fibrinogen levels and lower values for MCF FIBTEM (P<.05).ConclusionsThe ROTEM assays revealed severe alterations of the clot formation parameters and a high incidence of hyperfibrinolysis.Copyright © 2018 Elsevier España, S.L.U. y SEMICYUC. All rights reserved.

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