Data-driven development of ROTEM and TEG algorithms for the management of trauma hemorrhage: A prospective observational multicenter study

Annals of Surgery

Volumn 270, Issue 6, 2019, Pages 1178-1185

  Baksaas Aasen, Kjersti ^a   van Dieren, Susan ^b   Balvers, Kirsten ^b   Juffermans, Nicole P ^b   Næss, Pål A ^a   Rourke, Claire ^c   Eaglestone, Simon ^c   Ostrowski, Sisse R ^d   Stensballe, Jakob ^d   Stanworth, Simon ^e   Maegele, Marc ^f   Goslings, J C ^b   Johansson, Pär I ^d   Brohi, Karim ^c   Gaarder, Christine ^a   Bergman, R ^g   Campbell, H ^g   Curry, N ^g   Sturmer E K ^g   Schafer N ^g   Driessen, A ^g   Orr, A ^g   Gorlinger K ^g   Flaten N ^g   Kolstadbraaten, K M ^g   more..

^a OSLO UNIVERSITY HOSPITAL   (Norway)

^b ACADEMIC MEDICAL CENTER   (Netherlands)

^c QUEEN MARY UNIVERSITY OF LONDON   (United Kingdom)

^d University of Copenhagen   (Denmark)

^e JOHN RADCLIFFE HOSPITAL   (United Kingdom)

^f UNIVERSITY OF WITTEN HERDECKE   (Germany)

^g Oslo University Hospital ^*

Author keywords

Algorithms; ROTEM; TEG; Trauma hemorrhage; Trauma induced coagulopathy; Viscoelastic haemostatic assays

Indexed keywords

FIBRINOGEN; TRANEXAMIC ACID;

ADULT; ARTICLE; ASSAY; BLOOD CLOTTING DISORDER; BLOOD CLOTTING TEST; CLINICAL OUTCOME; CLINICAL PRACTICE; COHORT ANALYSIS; CONTROLLED STUDY; FEMALE; FIBRINOGEN BLOOD LEVEL; FIBRINOLYSIS; HUMAN; HYPOFIBRINOGENEMIA; INJURY; INTERNATIONAL NORMALIZED RATIO; MAJOR CLINICAL STUDY; MALE; MULTICENTER STUDY; OBSERVATIONAL STUDY; PRIORITY JOURNAL; PROSPECTIVE STUDY; RANDOMIZED CONTROLLED TRIAL; THROMBOCYTOPENIA; THROMBOELASTOGRAPHY; TRAUMA INDUCED COAGULOPATHY; VISCOELASTIC HEMOSTATIC ASSAY; VISCOELASTICITY; ALGORITHM; BLEEDING; CLINICAL TRIAL; COMPLICATION; MIDDLE AGED; SENSITIVITY AND SPECIFICITY;

ADULT; ALGORITHMS; BLOOD COAGULATION DISORDERS; BLOOD COAGULATION TESTS; FEMALE; HEMORRHAGE; HUMANS; MALE; MIDDLE AGED; PROSPECTIVE STUDIES; SENSITIVITY AND SPECIFICITY; THROMBELASTOGRAPHY; WOUNDS AND INJURIES;

EID: 85075095446     PISSN: 00034932     EISSN: 15281140     Source Type: Journal    
DOI: 10.1097/SLA.0000000000002825     Document Type: Article

References (36)

1. Wang H, Naghavi M, Allen C, et al. Articles Global, regional, and national life expectancy, all-cause mortality, and cause-specific mortality for 249 causes of death, 1980-2015: a systematic analysis for the Global Burden of Disease Study 2015. Lancet. 2016;388:1459–1544.
2. Mokdad AH, Forouzanfar MH, Daoud F, et al. Global burden of diseases, injuries, and risk factors for young people’s health during 1990-2013: a systematic analysis for the Global Burden of Disease Study 2013. Lancet. 2016;387:2383–2401.
3. Holcomb JB, Tilley BC, Baraniuk S, et al. Transfusion of plasma, platelets, and red blood cells in a 1:1:1 vs a 1:1:2 ratio and mortality in patients with severe trauma. JAMA. 2015;313:471–482.
4. Stanworth SJ, Davenport R, Curry N, et al. Mortality from trauma haemorrhage and opportunities for improvement in transfusion practice. Br J Surg. 2016;103:357–365.
5. Khan S, Brohi K, Chana M, et al. Hemostatic resuscitation is neither hemostatic nor resuscitative in trauma hemorrhage. J Trauma Acute Care Surg. 2014;76:561–568.
6. Khan S, Davenport R, Raza I, et al. Damage control resuscitation using blood component therapy in standard doses has a limited effect on coagulopathy during trauma hemorrhage. Intensive Care Med. 2014;41:239–247.
7. Stensballe J, Ostrowski SR, Johansson PI. Haemostatic resuscitation in trauma. Curr Opin in Crit Care. 2016;22:591–597.
8. Meledeo MA, Herzig MC, Bynum JA, et al. Acute traumatic coagulopathy: the elephant in a room of blind scientists. J Trauma Acute Care Surg. 2017;82:S33–S40.
9. Rossaint R, Bouillon B, Cerny V, et al. The European guideline on management of major bleeding and coagulopathy following trauma: fourth edition. Crit Care. 2016;20:1–55.
10. Nascimento B, Callum J, Tien H, et al. Effect of a fixed-ratio (1:1:1) transfusion protocol versus laboratory-results-guided transfusion in patients with severe trauma: a randomized feasibility trial. CMAJ. 2013;185:E583–E589.
11. Gonzalez E, Moore EE, Moore HB, et al. Goal-directed hemostatic resuscitation of trauma-induced coagulopathy. Ann Surg. 2016;263:1051–1059.
12. Frith D, Gosling JC, Gaarder C, et al. Definition and drivers of acute traumatic coagulopathy: clinical and experimental investigations. J Thromb Haemost. 2010;8:1919–1925.
13. Johansson PI, Sørensen AM, Larsen CF, et al. Low hemorrhage-related mortality in trauma patients in a Level I trauma center employing transfusion packages and early thromboelastography-directed hemostatic resuscitation with plasma and platelets. Transfusion. 2013;53:3088–3099.
14. Abdelfattah K, Cripps MW. Thromboelastography and rotational thromboelastometry use in trauma. Int J Surg. 2016;33:196–201.
15. Johansson PI, Stensballe J, Oliveri R, et al. How I treat patients with massive hemorrhage. Blood. 2014;124:3052–3058.
16. Afshari A, Wikkelsø A, Brok J, et al. Thrombelastography (TEG) or Thrombelastometry (ROTEM) to monitor haemotherapy versus usual care in patients with massive transfusion. Cochrane Database Syst Rev. 2011;16:CD007871.
17. Hunt H, Stanworth S, Curry N, et al. Thromboelastography (TEG) and rotational thromboelastometry (ROTEM) for trauma induced coagulopathy in adult trauma patients with bleeding. Cochrane Database Syst Rev. 2015;16:CD010438.
18. Da Luz LT, Nascimento B, Shankarakutty AK, et al. Effect of thromboelastography (TEG1) and rotational thromboelastometry (ROTEM1) on diagnosis of coagulopathy, transfusion guidance and mortality in trauma: descriptive systematic review. Crit Care. 2014;18:518.
19. National Institute of Health and Care Excellence (2016) Major Trauma: assessment and initial management (NICE Guidelines 39). Available at: https://www.nice.org.uk/guidance/ng39 [Accessed May 2018].
20. Wikkelsø A, Wetterslev J, Møller AM, et al. Thromboelastography (TEG) or Thromboelastometry (ROTEM) to monitor haemostatic treatment versus usual care in adults or children with bleeding. Cochrane Database Syst Rev. 2016;22:CD007871.
21. Veigas PV, Callum J, Rizoli S, et al. A systematic review on the rotational thrombelastometry (ROTEM1) values for the diagnosis of coagulopathy, prediction and guidance of blood transfusion and prediction of mortality in trauma patients. Scand J Trauma Resusc Emerg Med. 2016;24:114.
22. Einersen PM, Moore EE, Chapman MP, et al. Rapid-thrombelastography (rTEG) thresholds for goal-directed resuscitation of patients at risk for massive transfusion. J Trauma Acute Care Surg. 2017;82:114–119.
23. Inaba K, Rizoli S, Veigas PV, et al. 2014 Consensus conference on viscoelastic test-based transfusion guidelines for early trauma resuscitation. J Trauma Acute Care Surg. 2015;78:1220–1229.
24. TACTIC website. Available at: http://www.tacticgroup.dk.
25. INTRN website. Available at: http://www.intrn.org.
26. Ganter MT, Hofer CK. Coagulation monitoring: current techniques and clinical use of viscoelastic point-of-care coagulation devices. Anesth Analg. 2008;106:1366–1375.
27. Whiting D, DiNardo JA. TEG and ROTEM: Technology and clinical applications. Am J Hematol. 2014;89:228–232.
28. Clauss A. Rapid physiological coagulation method in determination of fibrinogen. Acta Haematol. 1957;17:237–246.
29. Rubin DB. Multiple imputation for nonresponse in surveys. New York: Wiley; 1987.
30. Schäfer N, Driessen A, Fröhlich M, et al. Diversity in clinical management and protocols for the treatment of major bleeding trauma patients across European level I Trauma Centres. Scand J Trauma Resusc Emerg Med. 2015;23:74.
31. Shakur H, Roberts I, Bautista R, et al. Effects of tranexamic acid on death, vascular occlusive events, and blood transfusion in trauma patients with significant haemorrhage (CRASH-2): a randomised, placebo-controlled trial. Lancet. 2010;376:23–32.
32. Cole E, Davenport R, Willett K, et al. Tranexamic acid use in severely injured civilian patients and the effects on outcomes. Ann Surg. 2015;261:390–394.
33. Jeger V, Zimmermann H, Aristomenis K, et al. Can RapidTEG accelerate the search for coagulopathies in the patient with multiple injuries? J Trauma. 2009;66:1253–1257.
34. Rourke C, Curry N, Khan S, et al. Fibrinogen levels during trauma hemorrhage, response to replacement therapy, and association with patient outcomes. J Thromb Haemost. 2012;10:1342–1351.
35. Gall L, Brohi K, Davenport R. Diagnosis and treatment of hyperfibrinolysis in trauma (a European perspective). Semin Thromb Hemost. 2017;43: 224–234.
36. Theusinger OM, Wanner GA, Emmert MY, et al. Hyperfibrinolysis diagnosed by rotational thromboelastometry (ROTEM1) is associated with higher mortality in patients with severe trauma. Anesth Analg. 2011;113: 1003–1012.