title: Thromboelastometry guided therapy of severe bleeding. Essener Runde algorithm.
abstract: Both, severe haemorrhage and blood transfusion are associated with increased morbidity and mortality. Therefore, it is of particular importance to stop perioperative bleeding as fast and as possible to avoid unnecessary transfusion. Viscoelastic test (ROTEM® or TEG®) allow for early prediction of massive transfusion and goal-directed therapy with specific haemostatic drugs, coagulation factor concentrates, and blood products. Growing consensus points out, that plasma-based coagulation screening tests like aPTT and PT are inappropriate for monitoring coagulopathy or guide transfusion therapy. Increasing evidence of more than 5000 surgical or trauma patients points towards the beneficial effects of a thrombelastography or -metry based approach in diagnosis and goal-directed therapy of perioperative massive haemorrhage. The Essener Runde task force is a group of clinicians of various specialties (anaesthesiology, intensive care, haemostaseology, haematology, internal medicine, transfusion medicine, surgery) interested in perioperative coagulation management. The ROTEM diagnostic algorithm of the Essener Runde task force was created to standardise and simplify the interpretation of ROTEM® results in perioperative settings and to present their possible implications for therapeutic interventions in severe bleeding. To exemplify, this text mainly focuses on coagulation management in trauma.
authors.affiliation: Department of Anaesthesiology and Intensive Care, Medicine University Hospital of Cologne, Kerpener Straße 62, 50937 Cologne, Germany. Heiko.Lier@uk-koeln.de
authors.forename: H
authors.initials: H
authors.lastname: Lier
authors.forename: M
authors.initials: M
authors.lastname: Vorweg
authors.forename: A
authors.initials: A
authors.lastname: Hanke
authors.forename: K
authors.initials: K
authors.lastname: Görlinger
mesh_terms: D000465:Algorithms; D020000:Decision Support Systems, Clinical; D006490:Hemostatics / Q000627:therapeutic use*; D006801:Humans; D019106:Postoperative Hemorrhage / Q000517:prevention & control*; D013916:Thrombelastography / Q000379:methods*; D065227:Transfusion Reaction
chemical_list: D006490:Hemostatics