Rotem Guided Bleeding Management

Abstract

Rotational thromboelastometry (ROTEM) enables the assessment of viscoelastic profiles of whole blood in a variety of clinical settings. ROTEM-guided bleeding management has become an essential part of patient blood management (PBM). ROTEM-guided PBM (Patient Blood Management) has been shown to be effective in reducing bleeding, transfusion requirements, complication rates, and healthcare costs. Several randomized controlled trials and meta-analyses have provided evidence that ROTEM guidance improves perioperative morbidity and mortality in bleeding patients. ROTEM results and the corresponding hemostatic interventions for common bleeding scenarios are discussed.

Keywords

• Viscoelastic Tests
• Rotational thromboelastometry
• Post-partum bleeding
• Post-traumatic bleeding
• Bleeding in cardiovascular surgery patients
• Transfusion management

Rotem Rehberliğinde Kanama Yönetimi

Öz

Rotasyonel tromboelastometri (ROTEM), çeşitli klinik ortamlarda tam kanın viskoelastik profillerinin değerlendirilmesini sağlar. ROTEM kılavuzluğunda kanama yönetimi, hasta kan yönetiminin (HKY) temel bir parçası haline gelmiştir. ROTEM kılavuzluğunda HKY; kanamayı, transfüzyon gereksinimlerini, komplikasyon oranlarını ve sağlık bakım maliyetlerini azaltmada etkili olduğu gösterilmiştir. Birkaç randomize kontrollü çalışma ve meta-analiz, kanayan hastalarda ROTEM rehberliğinin; peroperatif morbidite ve mortaliteyi iyileştirdiğine dair kanıt sağlamıştır. Sık görülen kanama senaryoları üzerinden ROTEM sonuçları ve bu sonuçlara göre yapılacak hemostatik müdahaleler tartışılmıştır.

Anahtar Kelimeler

• Viskoelastik testler
• rotasyonel tromboelastometri
• post-partum kanama
• post-travmatik kanama
• kardiyovasküler cerrahi hastasında kanama
• transfüzyon yönetimi

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