title: Comparison of conventional ROTEM® cups and pins to the ROTEM® cup and pin mini measuring cells (MiniCup).
abstract: BACKGROUND
  Thromboelastometry (ROTEM®) is a well-established measurement to guide perioperative coagulation management. Recently, an enhancement for low volume specimens using cup and pin mini measuring cells (MiniCup) was invented for scientific non-clinical use. The MiniCup measuring cells allow testing with half of the blood volume required to run a test as compared to the conventional ROTEM® cup and pin (150 μL vs. 300 μL per assay).
  
  
  OBJECTIVE
  The aim of this prospective study was to compare ROTEM® results using conventional cups and pins to the results of the MiniCup measuring cells.
  
  
  METHODS
  Blood samples drawn during major pediatric surgery were analyzed using the conventional ROTEM® and the MiniCup system to compare parameters from the EXTEM, INTEM and FIBTEM assays.
  
  
  RESULTS
  Citrated blood samples (n = 120) from 70 pediatric patients were analyzed. Results of the MiniCup cells were considerably different than the conventional ROTEM® cups and pins measurements. The MiniCup results show less clot firmness and demonstrate higher variability in the parameters reflecting the kinetics of clot building.
  
  
  CONCLUSIONS
  The MiniCup measuring cells may offer advantages in pediatric care or research facilities, but specific reference ranges need to be established first, and adequate reproducibility must be determined by further studies before clinical use can be recommended.
authors.affiliation: Department of Anesthesia, Zurich University Children's Hospital , Zurich , Switzerland.
authors.forename: Thorsten
authors.initials: T
authors.lastname: Haas
authors.forename: Nelly
authors.initials: N
authors.lastname: Spielmann
authors.forename: Claudia
authors.initials: C
authors.lastname: Dillier
authors.forename: Melissa
authors.initials: M
authors.lastname: Cushing
authors.forename: Svenja
authors.initials: S
authors.lastname: Siegmund
authors.forename: Bernard
authors.initials: B
authors.lastname: Krüger
mesh_terms: D001777:Blood Coagulation; D006801:Humans; D019990:Perioperative Care; D011446:Prospective Studies; D012016:Reference Values; D015203:Reproducibility of Results; D013916:Thrombelastography / Q000295:instrumentation* / Q000379:methods
keywords: Blood coagulation; pediatric anesthesia; point-of-care testing; thrombelastography; thromboelastometry