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Reproducibility of thrombelastometry (ROTEM®): point-of-care versus hospital laboratory performance


Haas, Thorsten; Spielmann, Nelly; Mauch, Jacqueline; Speer, Oliver; Schmugge, Markus; Weiss, Markus (2012). Reproducibility of thrombelastometry (ROTEM®): point-of-care versus hospital laboratory performance. Scandinavian Journal of Clinical and Laboratory Investigation, 72(4):313-317.

Abstract

Thrombelastometry (ROTEM®) has gained wide acceptance in detecting and tailoring acquired hemostatic changes in adults and children. We investigated in this observational trial whether the reproducibility of this point-of-care testing was influenced by performance at the bedside or in the hospital laboratory. In addition, difference in time of performance between both measurements was compared. Perioperative blood samples obtained during major pediatric surgery were run in duplicate on two different ROTEM® devices located in the OR and in the hospital laboratory. The Bland-Altman test was used to compare differences of both measurements. ROTEM® measurements of 90 blood samples obtained from 24 children showed no overall clinically meaningful differences, whether they were performed bedside or in the hospital laboratory. Minor differences were found for the InTEM clot formation time (CFT) showing a mean bias of 10.79 seconds. Time saving was 11 minutes (8-16 minutes) if ROTEM® measurements were performed bedside (p < 0.001). In conclusion, there were minimal effects on ROTEM® measurements irrespective of whether they were performed in the hospital laboratory or at the bedside by a single trained staff member, while the latter saved valuable time.

Thrombelastometry (ROTEM®) has gained wide acceptance in detecting and tailoring acquired hemostatic changes in adults and children. We investigated in this observational trial whether the reproducibility of this point-of-care testing was influenced by performance at the bedside or in the hospital laboratory. In addition, difference in time of performance between both measurements was compared. Perioperative blood samples obtained during major pediatric surgery were run in duplicate on two different ROTEM® devices located in the OR and in the hospital laboratory. The Bland-Altman test was used to compare differences of both measurements. ROTEM® measurements of 90 blood samples obtained from 24 children showed no overall clinically meaningful differences, whether they were performed bedside or in the hospital laboratory. Minor differences were found for the InTEM clot formation time (CFT) showing a mean bias of 10.79 seconds. Time saving was 11 minutes (8-16 minutes) if ROTEM® measurements were performed bedside (p < 0.001). In conclusion, there were minimal effects on ROTEM® measurements irrespective of whether they were performed in the hospital laboratory or at the bedside by a single trained staff member, while the latter saved valuable time.

Citations

15 citations in Web of Science®
24 citations in Scopus®
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Additional indexing

Item Type:Journal Article, refereed, original work
Communities & Collections:04 Faculty of Medicine > University Children's Hospital Zurich > Clinic for Surgery
Dewey Decimal Classification:610 Medicine & health
Language:English
Date:2012
Deposited On:09 Nov 2012 11:20
Last Modified:05 Apr 2016 16:03
Publisher:Informa Healthcare
ISSN:0036-5513
Publisher DOI:https://doi.org/10.3109/00365513.2012.665474
PubMed ID:22724625

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