Redefining haemostasis: Role of rotational thromboelastometry in critical care settings

Table 2 Rotational thromboelastometry parameters and their clinical significance

ROTEM parameters	Clinical significance
Clot initiation: Clotting time	The time from the beginning of the test until a significant increase in resistance is observed, marking the onset of initial fibrin formation
Clot kinetics: Clot formation time	The duration from CT to reaching a clot firmness of 20 mm, reflecting fibrin polymerization and clot stabilization with the involvement of activated platelets and fibrin-stabilizing factor XIII
Clot kinetics: Alpha angle	The slope during the early phase of clot development, represented by the angle between the tangent line from the baseline to a 20 mm amplitude, indicates the rate of fibrin accumulation and cross-linking
Clot strength: Maximum clot firmness	The highest resistance recorded, due to enhanced clot stabilization by polymerized fibrin, activated platelets, and factor XIII, represents the maximum strength of the clot
Clot strength: Maximum lysis	The percentage decrease in MCF at specific intervals of 30 and 60 minutes, indicating clot stability and breakdown

CT: Clotting time; MCF: Maximum clot firmness; ROTEM: Rotational thromboelastometry.