The ROTEM platelet system is a new module that can be added to the ROTEM, enabling simultaneous analysis of thromboelastometry measurements and platelet aggregation using impedance aggregometry.
Video 1.
Platelet aggregometry using ROTEM
Color coded graph for interpretation
Reference values of INTEM, HEPTEM, EXTEM, and FIBTEM
ROTEM TEMOGRAM with decreased Fibrinogen
ROTEM platelet aggregation graph
In ROTEM PM, effect of various antiplatelet drugs can be studied through single use agent; ARA-TEM for cyclooxygenase inhibitors, ADP-TEM for ADP receptor blocker and TRAP-TEM for glycoprotein IIbIIIa receptor blockers.
ROTEM platelet mapping system
ROTEM PM system3 is a new module that can be added to ROTEM, enabling simultaneous analysis of thromboelastometry & platelet aggregation using impedance aggregometry (Figure Below).
ROTEM monitor showing simultaneous graphs of thromboelastometry (upper 4) and platelet aggregometry (lower 2)
RAPID ASSESSMENT IN ONLY 10 MINUTES
IMPEDANCE AGGREGOMETRY: ACTIVATOR PATHWAYS
Impedance aggregometry: Activator pathways
ROTEM PLATELET ACTIVATORS AND PARAMETERS
Platelet aggregometry tests
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1.
Aratem – Arachidonic acid
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2.
Traptem – Thrombin activating Peptide
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3.
Adptem – Adenosine Diphosphate
Platelet Parameters
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1.
Amplitude at 6 Min.-A6 – It describes how well the platelets aggregate after selective activation.
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2.
Maximum Slope. MS – It describes how quick the platelets aggregate after selective activation.
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3.
Area Under the Curve-AUC- It reflects the overall platelet aggregation.
Graph showing different therapies
Graph showing increased and decreased clotting time
Administration of fibrinogen concentrate
Conclusion:
Major bleeding is a partially modifiable risk factor, and adequate preemptive and treatment strategies should be applied to limit this event. ROTEM PLATELET AGGREGOMETRY provides great blood product usage and is cost effective when used in time.