Expert interview on the new generation of devices ROTEM® sigma

ROTEM® technology expert and pioneer Dr. Thomas Lang Dr. Lang
(Gerinnungsambulanz and Medlab Südheide)
actively advised us with the development of the ROTEM® sigma.

As one of the first test centres for ROTEM® sigma, he afforded us an interview.

How long have you been using the ROTEM® system and why?
After we extensively compared the TEG® system with the ROTEG, we implemented thromboelastometry in 1999 in the Graz University (Austria) laboratory.
The delay to obtain results and the unsatisfactory evidence of classical coagulation parameters such as PT and aPTT in the context of heavy bleeding complications during and after surgery formed the main reason to implement additional coagulation diagnostics. Thromboelastometry insights became the basis for a timely and targeted coagulation therapy in the peri-operative setting.

What have been your experiences with the ROTEM® sigma?
Being an “old” ROTEM® user who likes to pipette and to perform new analytical experiments, I was generally pretty skeptical about a fully automated system.
As in every developmental stage, I noticed two irregularities during the test phase. They were promptly acknowledged the company and corrected.
After just a few test runs, I realized the use of the ROTEM® sigma is much easier than the ROTEM® delta. The ROTEM® sigma’s handling is reduced to the following steps: inserting the cartridge, reading the barcode and inserting the blood sample.

Which benefits does the automation afford you in your hectic daily routine?
In everyday clinical practice, the time saved by the use of ROTEM® sigma is substantial. There is no need for reagent handling and pipetting. Therefore operator input and possible sources of errors are minimized. The automatic test selection through the cartridge facilitates especially the new user’s work routine.

 In which clinical setting do you think the ROTEM® sigma should be used?
ROTEM® sigma is primarily a POC system. Its benefits will be most visible in the emergency room and in the operative setting. The reduced handling leads to SUBSTANTIAL time saving. Moreover, training efforts are reduced, the quality of results is assured and, especially interesting in the operative setting, qualified nursing staff may operate the system. In the laboratory however, I personally think the ROTEM® delta still has its value. Especially in this area, new ideas and developments can be boosted with the ROTEM® delta.

What would you wish for the future of ROTEM® sigma? How would you see the further development of the ROTEM® sigma?
I would wish for a small mark on the system, indicating the ideal position of the patient sample to be read by the barcode reader. For smaller labs, a dedicated waste bin for the cartridge (in which two needles are integrated) could be useful.
I also would like a special cartridge for the detection of NOAC’s or a cartridge with a higher sensitivity for lysis.
A platelet aggregation cartridge surely would be beneficial.

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