title: [Rotational thromboelastometry for the diagnosis of coagulation disorders].
abstract: Compared to conventional coagulation assays, as prothrombin time (PT) or activated partial thromboplastin time (aPTT), viscoelastic methods of coagulation analysis, including rotational thromboelastometry (ROTEM®, Tem International GmbH, Munich, Germany), yield prognostic benefits. Results of ROTEM® in citrated whole blood could be generated within 10-12 min and allow for a qualitative and semiquantitative characterisation of clot kinetics. Based on ROTEM® results, the switch between empiric approaches of treating coagulopathy to a goal-directed approach could be accelerated. Introduction of ROTEM® reduces transfusion requirements and the need for single factor concentrates. Thus, ROTEM® reduces transfusion-related adverse events, and additionally implement therapeutic cost effectiveness.
  
  
  
  This review provides a short introduction in the methodology of ROTEM®, showing how the combination of assays with different commercially available ROTEM® reagents allows for rapid differential diagnosis of common coagulopathies in clinical practice. Furthermore, prognostic benefits and limitations of ROTEM® diagnostics are described. Finally, we discuss the potential fields of ROTEM® application in different surgical settings.
  
  
  
  ROTEM® appears to be a contemporary, applicable and effective method in diagnosing coagulopathy and for subsequent algorithm-based goal-directed therapy.
authors.affiliation: Klinik für Anästhesiologie, Universitätsklinikum RWTH Aachen, Pauwelsstraße 30, 52074, Aachen, Deutschland. mhonickel@ukaachen.de.
authors.forename: M
authors.initials: M
authors.lastname: Honickel
authors.affiliation: Klinik für Anästhesiologie, Universitätsklinikum RWTH Aachen, Pauwelsstraße 30, 52074, Aachen, Deutschland.
authors.forename: O
authors.initials: O
authors.lastname: Grottke
mesh_terms: D001778:Blood Coagulation Disorders / Q000175:diagnosis; D001780:Blood Coagulation Tests; D006801:Humans; D010314:Partial Thromboplastin Time; D013916:Thrombelastography
keywords: Coagulation factor concentrates; Coagulopathy; Hyperfibrinolysis; ROTEM; Traumatology