REVIEW

 

ROTEM analysis: A significant advance in the field of rotational thrombelastography

 

 

R. C. Franz

M.B. Ch.B., M.Med. (chir.), M.D.; Emeritus Professor of Surgery, University of Pretoria, and Director, Fibrinolysis Laboratory, Department of Surgery, university of Pretoria

 

 

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ABSTRACT

At the turn of the century, a significant advance in the rapidly expanding field of rotational thrombelastography (ROTEG), known at present as thrombelastometry or ROTEM analysis, was developed at the Ludwig-Maximillian University in Munich. The measuring unit is operated by a laptop computer. There are four temperature-controlled measuring channels in which the global assays not only detect coagulation factor defects but also platelet function, abnormal fibrinogen polymerisation, anticoagulant defects and hyperfibrinolysis.
ROTEM has steadily increased in popularity, particularly because of its well-established application as a diagnostic aid at the point of care in the critical care situation. It also provides a useful guide in the choice of an appropriate therapeutic option in the bleeding patient, reducing costs by avoiding administration of costly component therapy such as fresh-frozen plasma, cryoprecipitate, platelet concentrates or antifibrinolytic agents.
As well as being useful in monitoring anticoagulant therapy and the use of pharmacological agents, ROTEM is a valuable research tool in the field of hypercoagulability, fibrinolysis, factor XIII activity and the ultimate phases of the blood coagulation process.

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