Evaluation of rotation thrombelastography for the diagnosis of hyperfibrinolysis in trauma patients  A. Levrat, A. Gros, L. Rugeri, K. Inaba, B. Floccard,

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Evaluation of rotation thrombelastography for the diagnosis of hyperfibrinolysis in trauma patients  A. Levrat, A. Gros, L. Rugeri, K. Inaba, B. Floccard, C. Negrier, J.-S. David  British Journal of Anaesthesia  Volume 100, Issue 6, Pages 792-797 (June 2008) DOI: 10.1093/bja/aen083 Copyright © 2008 British Journal of Anaesthesia Terms and Conditions

Fig 1 (a) Normal ROTEM® tracing with reference ranges in brackets. CT, clotting time; CFT, clotting formation time; CA, clot amplitude at 10 or 15 min; MCF, maximum clot firmness; CLI, clot lysis index at 30 or 60 min. (b) ROTEM® tracing depicting severe coagulation abnormalities (decrease of MCF and CA15 in EXTEM, absence of clot in FIBTEM) with hyperfibrinolysis (MCF-EXTEM <18 mm and ΔMCF >9%). Severe coagulation abnormalities were confirmed by standard coagulations parameters (INR: 4.7, fibrinogen: 0.4 g litre−1) and hyperfibrinolysis by an ELT score of 2. (c) ROTEM® tracing depicting severe coagulation abnormalities (decrease of MCF and CA15 in EXTEM, the absence of clot in FIBTEM) but without evidence of hyperfibrinolysis (MCF-EXTEM >18 mm and ΔMCF <7%). Severe coagulation abnormalities were confirmed by standard coagulation parameters (INR: 3.9, fibrinogen: 0.5 g litre−1) and the absence of hyperfibrinolysis by an ELT score of 0. (d) ROTEM® tracing depicting severe coagulation abnormalities with virtually no coagulation process on ROTEM® (no clot on any ROTEM® channel testing). Severe coagulation abnormalities were confirmed by standard coagulation parameters (INR: 10, fibrinogen: 0 g litre−1) and hyperfibrinolysis by an ELT score of 4. British Journal of Anaesthesia 2008 100, 792-797DOI: (10.1093/bja/aen083) Copyright © 2008 British Journal of Anaesthesia Terms and Conditions