Table 1.
Test | TF | Contact | Heparin effect | Detectable condition(s) | Hemostatic interventions |
---|---|---|---|---|---|
EXTEM | + | −a | Extrinsic pathway, PLT count, fibrinolysis | Plasma, PCC, or PLTs | |
FIBTEM | + | −a | Fibrinogen levelb | Cryo or fibrinogen conc. | |
APTEM | + | −a | Systemic fibrinolysisc | Antifibrinolytics | |
INTEM | + | + | Intrinsic pathway, PLT count, fibrinolysis | Plasma, protamine, or PLTs | |
HEPTEM | + | −a | Heparin effect | Same as INTEM |
ACT activated clotting time, Cryo cryoprecipitate, Fibrinogen conc. fibrinogen concentrate, PCC prothrombin complex concentrate, PLT platelet, TF tissue factor activator, Contact contact activator (ellagic acid)
aHeparin is neutralized by the reagent at concentrations up to 4–6 U/ml on EXTEM/FIBTEM/APTEM and 8 U/ml on HEPTEM
bConfirmatory test for hypofibrinogenemia; low clot firmness (amplitude) on other ROTEM® tests may indicate either thrombocytopenia or hypofibrinogenemia
cConfirmatory test for fibrinolysis; fibrinolysis may be shown on all the other ROTEM® tests