Table 1.
ROTEM® parameters on arrival | Haemostatic treatment administered in response to initial ROTEM® assessment | ROTEM® parameters following haemostatic treatment | ||||||||||||
---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
EXTEM | FIBTEM | EXTEM | FIBTEM | |||||||||||
ISS on arrival | CT (seconds) | A10 (mm) | MCF (mm) | MCF (mm) | Prothrombin complex concentrate (IU) | Fibrinogen concentrat | Tranexamic acid (g) | Platelet concentrate (U) | CT (seconds) | A10 (mm) | MCF (mm) | MCF (mm) | Outcome | |
1 | 25 | 130 | 31 | 44 | 3 | 2,000 | 6 | 2 | 0 | 65 | 42 | 54 | 12 | Survived |
2 | 25 | 75 | 37 | 48 | 5 | 0 | 2 | 0 | 0 | N/A | N/A | N/A | N/A | Survived |
3 | 34 | 59 | 54 | 62 | 10 | 0 | 1 | 0 | 0 | N/A | N/A | N/A | N/A | Survived |
4 | 43 | 70 | 35 | 43 | 3 | 0 | 3 | 0 | 0 | 40 | 32 | 34 | 10 | Surviveda |
5 | 34 | 95 | 40 | 51 | 7 | 500 | 2 | 0 | 0 | 62 | 42 | 54 | 8 | Surviveda |
6 | 25 | 167 | 18 | 29 | 2 | 1,000 | 5 | 2 | 2 | 62 | 39 | 50 | 10 | Survived |
7 | 66b | 216c | 14c | 22c | 0 | 1,000 | 7 | 2 | 2 | 59 | 38 | 51 | 13 | Diedd |
8 | 66b | 139c | 22c | 34c | 0 | 2,000 | 8 | 2 | 2 | 74 | 26 | 38 | 8 | Diedd |
9 | 34 | 71 | 46 | 56 | 10 | 0 | 3 | 0 | 0 | 61 | 56 | 65 | 14 | Survived |
10 | 27 | 170 | 20 | 32 | 3 | 1,500 | 6 | 2 | 2 | 50 | 39 | 50 | 12 | Survived |
11 | 45 | 102 | 28 | 37 | 5 | 1,500 | 3 | 2 | 1 | 48 | 53 | 63 | 12 | Diedf |
12 | 36 | 114 | 20 | 29 | 5 | 1,500 | 4 | 2 | 1 | 61 | 39 | 48 | 9 | Surviveda |
A10, clot amplitude (firmness) 10 minutes after clotting time (CT); EXTEM, extrinsically activated thromboelastometric test; FIBTEM, thromboelastometric test of fibrin-based clotting; ISS, injury severity score; IU, international units; MCF, maximum clot firmness; N/A, not available. aPatient received platelets following the second ROTEM® assessment. bFulminant hyperfibrinolysis was detected, so aprotinin-controlled thromboelastometric test (APTEM) parameters were initially used to guide treatment. Both patients also received fresh frozen plasma after the second ROTEM® assessment. cValue obtained using the APTEM assay. dCause of death was multiple organ failure. eCause of death was abdominal aortic rupture and unstoppable haemorrhage. fCause of death was brain death.