In-vitro comparison of free oscillation rheometry (ReoRox) and rotational thromboelastometry (ROTEM) in trauma patients upon hospital admission

• Published in: Blood coagulation & fibrinolysis Vol. 23; no. 8; p. 688
• Main Authors: Sølbeck, Sacha, Windeløv, Nis A, Bæk, Nicolai H, Nielsen, Jørn D, Ostrowski, Sisse R, Johansson, Pär I
• Format: Journal Article
• Language: English
• Published: England 01.12.2012
• Subjects: Adolescent; Adult; Aged; Aged, 80 and over; Blood Coagulation; Female; Humans; Male; Middle Aged; Patient Admission; Point-of-Care Systems - standards; Prospective Studies; Thrombelastography - instrumentation; Thrombelastography - methods; Trauma Centers; Whole Blood Coagulation Time - methods; Wounds and Injuries - blood
• ISSN: 1473-5733
• DOI: 10.1097/MBC.0b013e328351ebd6

Plasma-based assays do not provide accurate information on haemostatic resuscitation hence viscoelastic point-of-care haemostatic assays such as rotational thromboelastometry (ROTEM Delta, Pentapharm) are used to monitor coagulopathy in trauma patients. Free oscillation rheometry (FOR) is a new whole blood haemostatic assay that measures not only the clot-forming process but also the initial viscous phase; this could potentially be of value when assessing traumatic coagulopathy. A comparative analysis between FOR and ROTEM was therefore performed. This is a prospective observational study of 40 adult trauma patients admitted to a level 1 trauma centre. Citrated whole blood was analysed with ROTEM EXTEM and FIBTEM assays and FOR Fibscreen1 and Fibscreen2 assays. Predefined variables of ROTEM and FOR were compared using Spearman's ρ. ROTEM maximum clot function (MCF) in both EXTEM and FIBTEM correlated (P < 0.0001 for both) with FOR maximum elasticity Fibscreen1 and Fibscreen2, respectively. Interestingly, ROTEM EXTEM clotting time did not correlate with any of the FOR clot initiation parameters COT1, COT2 or COT2-1 of Fibscreen1. A correlation between ROTEM EXTEM and FIBTEM and FOR Fibscreen1 and Fibscreen2 clot formation and clot strength was found as was a significant correlation between lysis index after 60 min and ClotSR30. ROTEM EXTEM did not correlate with COT1, COT2 or COT2-1 of Fibscreen1 and this warrants further investigation.