ROTEM Flashcards
Component Therapy
PRBCs contain what?
preservative
anticoagulant
~ 50mL plasma
50-80 gm Hgb
~ 250mg Fe
Component Therapy
Platelets typically given as pool of what?
6 whole blood derived platelets from random donors (6pack)
Component Therapy
FFP contains what?
clotting factors, fibrinogen, plasma proteins (albumin), physiologic anticoagulants
Component Therapy
Cryoprecipitate contains what?
concentrate prepared from FFP
contains VIII, vWF, fibrinogen
EXTEM is what?
INTEM is what?
FIBTEM is what?
activation of clot via extrinsic pathway (VII, X, V, II, I, platelets fibrinolysis)
activation of clot via intrinsic pathway; sensitive to heparin (XII, XI, IX, VIII, X, V, II, I, platelets fibrinolysis)
platelet inhibition agent aded to isolate fibrinogen contribution
APTEM is what?
HEPTEM is what?
Clotting time (CT) is what?
Maximum Clot Firmness (MCF) is what?
Maximum Lysis (ML) is what?
Aprotinin (or TXA) added to identify hyperfibrinolysis
Addition of heparinase to assess heparin related coagulation disturbances
from start time to initiation of clot
firmness of clot
reduction in clot firmness after MCF
Approach to Interpretation
Step 1: How fast does clot form?
look @ what in ROTEM? and what in TEG?
If prolonged, give what?
CT; R
FFP or PCC (prothrombin complex concentrate)
Approach to Interpretation
Step 2: How strong?
Look @ what?
If low, look @ what?
MCF in EXTEM/INTEM
MCF in FIBTEM
Approach to Interpretation
Step 2: How strong?
if MCF low in FIBTEM, give what?
if MCF normal in FIBTEM, give what?
cryoprecipitate
platelets
Approach to Interpretation
Step 3: For how long?
is clot breaking down sooner than it should?
Look @ fibrinolysis/maximum lysis (ML) what time in ROTEM? what time in TEG?
if prolonged or tadpoling, check ML where? if 0% give what?
30 min; 30 or 60 min
APTEM
TXA
