Comparison of diagnostic capabilities of thromboelastometry (rotem) and coagulogram after aortic surgery: 616.1

Abstract

Summary. Aim: to compare diagnostic options of thromboelastometry (ROTEM) and conventional coagulation tests in detecting and managing hemostasis disorders during the postoperative period in patients undergoing aortic surgery with the use of cardiopulmonary bypass and/or circulatory arrest. Materials and Methods. A pilot non-randomized prospective single-center study enrolled 81 patients who underwent aortic surgery with the use of cardiopulmonary bypass and/or circulatory arrest between November 2021 and October 2022 (ClinicalTrials.gov ID: NCT05171023). Measurements (ROTEM and conventional coagulation tests) were performed upon admission (value No 1) to the intensive care unit (ICU), 6 hours after admission (value No 2), in case of severe postoperative hemostasis disorders — blood loss > 100 mL/h or > 500 mL in 3 hours, or thrombosis (value No 3). After neutralization of postoperative significant hemostasis disturbances, a control measurement was performed (value No 4). Results. Our study found no substantial correlation between ROTEM and conventional coagulation tests. However, ROTEM INTEM CFT and INTEM alpha angle data upon admission to the ICU allow to determine an algorithm for allocating a patient into the risk group of severe postoperative hemostasis disorders. The algorithm displays a sensitivity of 0.80, a specificity of 0.81, and statistical significance of p < 0.01. ROTEM NATEM CFT and NATEM A10 data can be used to predict excessive postoperative bleeding. Conclusion. The diagnostic capabilities of ROTEM surpass those of conventional coagulation tests in predicting severe hemostasis disorders and excessive bleeding in the postoperative period in patients who underwent aortic surgery.

For citation: Rizun L.I., Dymova O.V., Eremenko A.A. Comparison of diagnostic capabilities of thromboelastometry (ROTEM) and coagulogram after aortic surgery. Tromboz, gemostaz i reologiya. 2023;(4):31–39. (In Russ.).

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