Kataria S, Juneja D, Singh O. Redefining haemostasis: Role of rotational thromboelastometry in critical care settings. World J Crit Care Med 2025; 14(2): 102521 [DOI: 10.5492/wjccm.v14.i2.102521]
Corresponding Author of This Article
Deven Juneja, Institute of Critical Care Medicine, Max Super Speciality Hospital, Saket, 1 Press Enclave Road, New Delhi 110017, India. devenjuneja@gmail.com
Research Domain of This Article
Critical Care Medicine
Article-Type of This Article
Minireviews
Open-Access Policy of This Article
This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
World J Crit Care Med. Jun 9, 2025; 14(2): 102521 Published online Jun 9, 2025. doi: 10.5492/wjccm.v14.i2.102521
Redefining haemostasis: Role of rotational thromboelastometry in critical care settings
Sahil Kataria, Deven Juneja, Omender Singh
Sahil Kataria, Department of Critical Care Medicine, Holy Family Hospital, New Delhi 110025, India
Deven Juneja, Omender Singh, Institute of Critical Care Medicine, Max Super Speciality Hospital, New Delhi 110017, India
Author contributions: Kataria S and Juneja D performed the majority of the writing, and researched the project; Kataria S prepared the figures and tables and performed data accusation; Singh O provided inputs in writing; All three authors reviewed the manuscript.
Conflict-of-interest statement: The authors declare that they have no conflict of interest.
Open Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Deven Juneja, Institute of Critical Care Medicine, Max Super Speciality Hospital, Saket, 1 Press Enclave Road, New Delhi 110017, India. devenjuneja@gmail.com
Received: October 21, 2024 Revised: January 20, 2025 Accepted: February 8, 2025 Published online: June 9, 2025 Processing time: 129 Days and 20 Hours
Abstract
Management of patients with acute hemorrhage requires addressing the source of bleeding, replenishing blood volume, and addressing any coagulopathy that may be present. Assessing coagulopathy and predicting blood requirements in real-time in patients experiencing ongoing bleeding can pose substantial challenges. In these patients, transfusion concepts based on ratios do not effectively address coagulopathy or reduce mortality. Moreover, ratio-based concepts do not stop bleeding; instead, they just give physicians more time to identify the bleeding source and plan management strategies. In clinical practice, standard laboratory coagulation tests (SLCT) are frequently used to assess various aspects of blood clotting. However, these tests may not always offer a comprehensive understanding of clinically significant coagulopathy and the severity of blood loss. Furthermore, the SLCT have a considerable turnaround time, which may not be ideal for making prompt clinical decisions. In recent years, there has been a growing interest in point-of-care viscoelastic assays like rotational thromboelastometry, which provide real-time, dynamic information about clot formation and dissolution.
Core Tip: Point of care viscoelastic tests like rotational thromboelastometry (ROTEM) can provide real-time, dynamic information about clot formation and dissolution and prove to be a valuable tool for assessing coagulation in numerous critical care settings. Unlike traditional coagulation tests, ROTEM can provide whole-blood evaluations which may aid the physicians to quickly identify coagulation issues and administer targeted treatments. With emerging technology and increasing clinical experience, new applications may emerge, and ROTEM may become an integral part of modern haemostatic management.
