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dc.contributor.authorBlayney, A
dc.contributor.authorMcCullough, J
dc.contributor.authorWake, E
dc.contributor.authorWalters, K
dc.contributor.authorCampbell, D
dc.contributor.authorHo, D
dc.contributor.authorChan, E
dc.contributor.authorChalasani, A
dc.contributor.authorWinearls, J
dc.date.accessioned2021-08-18T05:05:50Z
dc.date.available2021-08-18T05:05:50Z
dc.date.issued2021
dc.identifier.issn1863-9933
dc.identifier.doi10.1007/s00068-021-01652-w
dc.identifier.urihttp://hdl.handle.net/10072/407063
dc.description.abstractPurpose: Rotational thromboelastometry (ROTEM®) allows guided blood product resuscitation to correct trauma-induced coagulopathy in bleeding trauma patients. FIBTEM amplitude at 10 min (A10) has been widely used to identify hypofibrinogenaemia; locally a threshold of < 11 mm has guided fibrinogen replacement. Amplitude at 5 min (A5) carries an inherent time advantage. The primary aim was to explore the relationship between FIBTEM A5 and A10 in a trauma. Secondary aim was to investigate the use of A5 as a surrogate for A10 within a fibrinogen-replacement algorithm. Methods: Retrospective observational cohort study of arrival ROTEM results from 1539 consecutive trauma patients at a Level 1 trauma centre in Australia. Consistency of agreement between FIBTEM A5 and A10 was assessed. A new fibrinogen replacement threshold was developed for A5 using the A5–A10 bias; this was clinically compared to the existing A10 threshold. Results: FIBTEM A5 displayed excellent consistency of agreement with A10. Intraclass correlation coefficient = 0.972 (95% confidence interval [CI] 0.969–0.974). Bias of A5 to A10 was − 1.49 (95% CI 1.43–1.56) mm. 19.34% patients met the original local threshold of A10 < 11 mm; 19.28% patients met the new, bias-adjusted threshold of A5 < 10 mm. Conclusion: ROTEM FIBTEM A5 reliably predicts A10 in trauma. This further validates use of the A5 result over A10 allowing faster decision-making in time-critical resuscitation of trauma patients. A modification of -1 to the A10 threshold might be appropriate for use with the A5 value in trauma patients.
dc.description.peerreviewedYes
dc.languageen
dc.publisherSpringer Science and Business Media LLC
dc.relation.ispartofjournalEuropean Journal of Trauma and Emergency Surgery
dc.subject.fieldofresearchClinical sciences
dc.subject.fieldofresearchcode3202
dc.titleSubstitution of ROTEM FIBTEM A5 for A10 in trauma: an observational study building a case for more rapid analysis of coagulopathy
dc.typeJournal article
dc.type.descriptionC1 - Articles
dcterms.bibliographicCitationBlayney, A; McCullough, J; Wake, E; Walters, K; Campbell, D; Ho, D; Chan, E; Chalasani, A; Winearls, J, Substitution of ROTEM FIBTEM A5 for A10 in trauma: an observational study building a case for more rapid analysis of coagulopathy, European Journal of Trauma and Emergency Surgery, 2021
dc.date.updated2021-08-16T23:58:03Z
dc.description.versionAccepted Manuscript (AM)
gro.description.notepublicThis publication has been entered as an advanced online version in Griffith Research Online.
gro.rights.copyright© Springer-Verlag GmbH Germany, part of Springer Nature 2021. This is an electronic version of an article published in European Journal of Trauma and Emergency Surgery, 2021. European Journal of Trauma and Emergency Surgery is available online at: http://link.springer.com/ with the open URL of your article.
gro.hasfulltextFull Text
gro.griffith.authorCampbell, Donald G.
gro.griffith.authorHo, Debbie T.
gro.griffith.authorChan, Erick C.
gro.griffith.authorWake, Liz


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