ap-TEM®: Identification of hyperfibrinolysis
Hyperfibrinolysis is a frequently missed disorder and can be associated with severe bleeding. However, in a complex situation with several haemostasis abnormalities, hyperfibrinolysis is difficult to assess though it may already derogate clot formation and stability. Hyperfibrinolysis impairs therapy with platelets and fibrinogen and thus should be treated with priority.
APTEM is a method in which a fibrinolysis inhibitor (aprotinin) in the ap-TEM® reagent is used together with ex-TEM® activation. Aprotinin inactivates plasmin immediately.
The combination of EXTEM and APTEM confirms or rules out hyperfibrinolysis. The APTEM assay provides also information, if antifibrinolytic treatment with aprotinin will correct hyperfibrinolysis.
This enables major cost savings when less expensive antifibrinolytic drugs are given instead of blood products- and it may also lead to a shortening of the critical phase.
EXTEM, INTEM, FIBTEM and APTEM from a patient during hyperfibrinolysis, which is clearly seen in EXTEM, INTEM and FIBTEM. APTEM reveals a normal clot formation when fibrinolysis is inhibited. Based on these results the patient was successfully treated by aprotinin infusion.