A prospective evaluation of thromboelastometry (ROTEM) to identify acute traumatic coagulopathy and predict massive transfusion in military trauma patients in Afghanistan

Abstract

Hemorrhage is the leading cause of preventable trauma‐related mortality and is frequently aggravated by acute traumatic coagulopathy (ATC). Viscoelastic tests such as rotational thromboelastometry (ROTEM) may improve identification and management of ATC. This study aimed to prospectively evaluate changes in ROTEM among combat casualties during the first 24 hours and compare the capabilities of our conventional clotting assay (international normalized ratio [INR], >1.2) to a proposed integrated ROTEM model (INR >1.2 with the addition of tissue factor pathway activation thromboelastometry [EXTEM] A5 ≤35 mm and/or EXTEM LI30 <97% on admission) to identify ATC and predict massive transfusion (MT).

Document Details

Document Type
Pub Defense Publication
Publication Date
Apr 01, 2019
Source ID
10.1111/trf.15176

Entities

People

  • Andrew P Cap
  • Chriselda Fedyk
  • Christopher White
  • Hana Kwan
  • Heather Pidcoke
  • Ian J Stewart
  • Jared Cohen
  • Jonathan Sosnov
  • Kelly Heegard
  • Kevin K Chung
  • Thomas Scorer
  • Zachary Wright

Organizations

  • Aviano Air Base
  • David Grant USAF Medical Center
  • Keesler Air Force Base
  • Uniformed Services University of the Health Sciences
  • United States Army Medical Research and Development Command
  • University of Bristol

Tags

Fields of Study

  • Medicine

Readers

  • Trauma Surgery or Emergency Medicine.
  • Trauma or Military Medicine