title: [Role of thrombelastometry for the monitoring of factor XIII. A prospective observational study in neurosurgical patients].
abstract: Recently published studies give evidence, that an increased maximum lysis in the APTEM® - test (ML60 > 12%) of the ROTEM® (Tem International GmbH, Munich, Germany) might indicate a factor XIII deficiency (FXIII < 70%). It was the aim of this study to investigate the feasibility of thrombelastometric measurements with the ROTEM device to reflect the isolated influence of FXIII on clot stability and therefore to indicate potential factor XIII deficiencies.
  
  
  METHODS
  After approval by the local Scientific and Ethic Review Board, 26 consecutive patients, scheduled for elective craniotomy for tumour resection, were prospectively enrolled into this study. Blood samples were taken for conventional laboratory coagulation analyses, FXIII analyses and thrombelastometric measurements (EXTEM, FIBTEM and APTEM tests) after induction of general anaesthesia (T1), before skin incision (T2) as well as at (T3) and 24 hours after (T4) postoperative admission to ICU, respectively. Statistical analyses included Spearman rank order correlations and multiple linear regressions.
  
  
  RESULTS
  FXIII concentrations did not correlate with the ML60 in the APTEM test at any measuring point. Neither platelet count nor fibrinogen nor FXIII concentrations were of predictive value for ML60 of the APTEM test.
  
  
  CONCLUSIONS
  The results lead to the assumption that thrombelastometric measurements may not be appropriate for the perioperative monitoring of FXIII concentration.
authors.affiliation: Klinik für Anästhesiologie, Intensivmedizin u. Schmerztherapie, Klinikum der J.-W.-Goethe-Universität Theodor-Stern-Kai 7, 60590 Frankfurt am Main. christian.weber@kgu.de
authors.forename: C F
authors.initials: CF
authors.lastname: Weber
authors.forename: J O
authors.initials: JO
authors.lastname: Sanders
authors.forename: K
authors.initials: K
authors.lastname: Friedrich
authors.forename: R
authors.initials: R
authors.lastname: Gerlach
authors.forename: J
authors.initials: J
authors.lastname: Platz
authors.forename: W
authors.initials: W
authors.lastname: Miesbach
authors.forename: A A
authors.initials: AA
authors.lastname: Hanke
authors.forename: C
authors.initials: C
authors.lastname: Hofstetter
mesh_terms: D001932:Brain Neoplasms / Q000097:blood / Q000601:surgery*; D003399:Craniotomy; D005176:Factor XIII / Q000032:analysis*; D005177:Factor XIII Deficiency / Q000097:blood / Q000175:diagnosis*; D005240:Feasibility Studies; D006801:Humans; D011237:Predictive Value of Tests; D011300:Preoperative Care; D011446:Prospective Studies; D013916:Thrombelastography / Q000295:instrumentation*
chemical_list: D005176:Factor XIII