title: Peculiar whole blood rotation thromboelastometry (Rotem) profile in 40 sideropenic anaemia patients.
abstract: The ROtation ThromboElastoMetry analyser (ROTEM, Pentapharm, Munich, Germany) is useful for studying whole blood (WB) clot formation and lysis. Reduction of haematocrit (HCT) has been reported to influence traditional thromboelastography parameters without compromising "in vitro" blood coagulation. We performed this case-control study to evaluate ROTEM profiles in sideropenic anaemia patients with different degrees of reduction of HCT levels. Forty consecutively referred patients with sideropenic anaemia were enrolled. A group of 40 healthy age and gender matched subjects acted as a control. The influence of HCT on ROTEM was assessed in the study population and in a model of artificially reconstituted blood with modified HCT values. Cases presented significantly increased levels of maximum clot firmness (MCF) as compared to controls (p < 0.001) mimicking a sort of "hypercoagulable profile". However, thrombin generation tests failed to detect an increase in thrombin generation in cases as compared to controls. A statistically significant inverse linear correlation between HCT and MCF (p < 0.0001) was found. In addition, ROTEM profiles following "in vitro" manipulation of HCT confirmed the inverse linear correlation between HCT and MCF found in the study population. In conclusion, the increased clot firmness found by ROTEM in anaemic patients is likely to be related to the method in itself rather than representing a marker of hypercoagulability "in vivo". Since ROTEM is widely used by anaesthesiologists when deciding the optimisation of products supplementation during surgery, attention should be paid in the case of anaemic patients taking depending on the peculiar thrombo-elastography profile found.
authors.affiliation: Department of Cardia, Thoracic and Vascular Sciences, 2nd Chair of Internal Medicine, University of Padua Medical School, Via Ospedale 105, 35100 Padua, Italy.
authors.forename: Luca
authors.initials: L
authors.lastname: Spiezia
authors.forename: Claudia
authors.initials: C
authors.lastname: Radu
authors.forename: Paolo
authors.initials: P
authors.lastname: Marchioro
authors.forename: Diana
authors.initials: D
authors.lastname: Bertini
authors.forename: Valeria
authors.initials: V
authors.lastname: Rossetto
authors.forename: Monica
authors.initials: M
authors.lastname: Castelli
authors.forename: Antonio
authors.initials: A
authors.lastname: Pagnan
authors.forename: Benny
authors.initials: B
authors.lastname: Sørensen
authors.forename: Paolo
authors.initials: P
authors.lastname: Simioni
mesh_terms: D000368:Aged; D000740:Anemia / Q000097:blood*; D016477:Artifacts; D001777:Blood Coagulation; D016022:Case-Control Studies; D004867:Equipment Design; D005260:Female; D006400:Hematocrit; D006801:Humans; D008297:Male; D008875:Middle Aged; D011237:Predictive Value of Tests; D015203:Reproducibility of Results; D013916:Thrombelastography / Q000295:instrumentation*; D013917:Thrombin / Q000378:metabolism
chemical_list: D013917:Thrombin