Tomori Toshiki, Hupalo Daniel, Teranishi Kohsuke, Michaud Sarah, Hammett Mike, Freilich Daniel, McCarron Richard, Arnaud Françoise
Department of Trauma and Resuscitative Medicine, Naval Medical Research Center, Silver Spring, Maryland 20910-7500, USA.
Blood Coagul Fibrinolysis. 2010 Jan;21(1):20-7. doi: 10.1097/MBC.0b013e32833113e9.
Thromboelastography (TEG) or rotational thromboelastometry (ROTEM) assesses blood viscoelastic properties and clotting kinetics that can be measured by Haemoscope TEG and Pentapharm ROTEM devices using slightly different methodologies. These devices were compared by measuring blood samples associated with various degrees of coagulopathy. Blood samples, collected from swine undergoing three types of severe injury and resuscitation protocol resulting in normal, hypercoagulopathy, and hypocoagulopathy, were assessed with TEG or ROTEM before the surgical procedures, and after injury, fluid resuscitation, and simulated hospital phase. Standard clotting parameters were compared by Student's t-test at a significance of a P value less than 0.05. Regression analysis indicated a positive correlation between TEG and ROTEM for reaction time (R), clotting rate (K), and maximum amplitude (Ma) parameters. With samples of normal coagulation, R (440 +/- 136 vs. 391 +/- 73 s), K (99 +/- 39 vs. 81 +/- 20 s), and Ma (74 +/- 4 vs. 69 +/- 5 mm) were higher, whereas (alpha) (68 +/- 8 vs. 75 +/- 3 mm) was lower with TEG than ROTEM, respectively; a P value is less than 0.05. The magnitude of changes from baseline in hypercoagulable or hypocoagulable samples due to level of injury was equivalent with TEG and ROTEM indicating comparable use of the instruments. However, when samples were extremely hypocoagulopathic due to resuscitation fluid, the TEG values could not be readily determined. Overall, TEG readings were higher than ROTEM readings; this disparity between the two instruments was attenuated with hypercoaguable samples. Both devices yielded similar information regarding the status of coagulation related to trauma. Because of operating characteristics, the same instrument should be used for monitoring the same patient or study.
血栓弹力图（TEG）或旋转血栓弹力测定法（ROTEM）可评估血液的粘弹性特性和凝血动力学，可使用略有不同的方法通过血液凝固分析仪TEG和Pentapharm ROTEM设备进行测量。通过测量与各种程度凝血病相关的血样对这些设备进行比较。从接受三种导致正常、高凝血症和低凝血症的严重损伤及复苏方案的猪身上采集血样，在手术前、损伤后、液体复苏后及模拟住院阶段用TEG或ROTEM进行评估。通过学生t检验比较标准凝血参数，显著性P值小于0.05。回归分析表明，TEG和ROTEM在反应时间（R）、凝血速率（K）和最大振幅（Ma）参数方面呈正相关。对于正常凝血样本，TEG的R（440±136 vs. 391±73秒）、K（99±39 vs. 81±20秒）和Ma（74±4 vs. 69±5毫米）较高，而α角（68±8 vs. 75±3毫米）较低；P值小于0.05。由于损伤程度导致的高凝或低凝样本相对于基线的变化幅度，TEG和ROTEM相当，表明这两种仪器的使用效果相当。然而，当样本因复苏液而极度低凝时，TEG值无法轻易确定。总体而言，TEG读数高于ROTEM读数；两种仪器之间的这种差异在高凝样本中有所减弱。两种设备在与创伤相关的凝血状态方面提供了相似的信息。由于操作特性，应使用同一台仪器监测同一患者或进行同一项研究。
