Normal patient:

Platelet deficiency:

Fibrinogen deficiency:

Hyperfibrinolysis:

Heparin influence:

Result Interpretation

The assessment of the ROTEM^® analysis is carried out along the time axis (from left to right):

A disturbed activation of coagulation is indicated

by a prolonged clotting time. As causes, a factor deficiency or a heparin effect have to be considered. The comparison of INTEM and HEPTEM allows for a specific detection of a heparin effect.

An abnormal clot formation is indicated by a prolonged clot formation time (CFT) and/or a reduced clot firmness (MCF). The CFT is thereby

influenced more strongly by a clot polymerisation disorder than the MCF. A prolonged CFT, with at the same time normal MCF, indicates therefore

a polymerisation disorder, whereas a reduced MCF with a normal CFT rather indicates a deficiency of clottable substrate (fibrinogen and / or

Fibrinolysis is detected by the lysis of the clot (ML > 15%) or by the finding of a better clot formation (shorter CFT, greater MCF) in APTEM as compared to EXTEM. Several centres already use, in massive bleeding, a shortening of the CT in APTEM, as compared to EXTEM, as a trigger for an antifibrinolytic drug administration.

In summary the ROTEM^® analysis provides:

• Rapid information from the beginning of clot formation until its dissolution

• Concentration and activity of coagulation factors (incl. F XIII)
• Effects of anticoagulants like heparin or hirudin