Platelet aggregometry interpretation using ROTEM - PART - II.

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.

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

Aratem – Arachidonic acid

Traptem – Thrombin activating Peptide

Adptem – Adenosine Diphosphate

Platelet Parameters

Amplitude at 6 Min.-A6 – It describes how well the platelets aggregate after selective activation.

Maximum Slope. MS – It describes how quick the platelets aggregate after selective activation.

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.