tromboelastomeetriat

Tromboelastomeetria, often referred to as rotational thromboelastometry (ROTEM) or automated thromboelastography (TEG), is a viscoelastic assay used to assess the hemostatic function of a patient's blood. It measures the dynamic changes in clot formation, strength, and lysis in whole blood. The technique involves a sample of blood placed in a disposable cuvette which is oscillated. A probe immersed in the blood moves with the cuvette. As the blood coagulates, the increasing viscosity resists the probe's movement, and this resistance is measured and plotted over time, creating a characteristic waveform.

Different parameters are analyzed from the ROTEM or TEG tracing, providing insights into the various phases of coagulation. These include the time it takes for the clot to initiate (clotting time or reaction time), the speed of clot formation (alpha angle or rate of clot formation), the maximum clot strength (maximum amplitude or maximal clot firmness), and the degree of clot lysis over time. These parameters can help identify specific hemostatic abnormalities such as deficiencies in clotting factors, platelet dysfunction, or hypercoagulability.

Tromboelastomeetria is particularly valuable in managing patients with significant bleeding, such as those undergoing major surgery or trauma, or in intensive care settings. It allows for rapid and comprehensive assessment of the hemostatic system, guiding targeted interventions like the administration of blood products (e.g., fresh frozen plasma, cryoprecipitate, platelets) or procoagulant medications. This point-of-care testing can optimize transfusion strategies, potentially reducing blood product usage and improving patient outcomes. The interpretation of the results requires clinical context and expertise.