The assessment of the ROTEM® analysis is carried out along the time axis (from left to right): A disturbed activation of coagulation is indicated by a prolonged clotting time (CT). As causes, a factor deficiency or a heparin effect should be considered. The comparison of INTEM and HEPTEM allows for a specific detection of a heparin effect. An abnormal clot formation is indicated by a prolonged clot formation time (CFT) and/or a reduced clot firmness (MCF). The CFT is thereby influenced more strongly by a clot polymerization disorder than the MCF. A prolonged CFT, with at the same time normal MCF, therefore indicates a polymerization disorder, whereas a reduced MCF with a normal CFT indicates a deficiency of clottable substrate (fibrinogen and / or platelets).Fibrinolysis is detected by the lysis of the clot (ML > 15%) or by the finding of a better clot formation (shorter CFT, greater MCF) in APTEM as compared to EXTEM. Several centers already use (in massive bleeding) a shortening of the CT in APTEM, as compared to EXTEM, as a trigger for an antifibrinolytic drug administration.
Learn the basics of interpretation and clinical application of thromboelastometry with this training video: