Vox sanguinis
September 23, 2026 · via Europe PMC
Rotational thromboelastometry-guided transfusion in acute trauma: Less plasma, greater precision.
Dinić R, Šabani A, Životić B, Horvacki N, Mladenović N, Grujić J.
AI summary — for doctors, generated from the abstract only
ROTEM-guided management in bleeding trauma patients was associated with less plasma, more cryoprecipitate and shorter ICU stay, without differences in RBC use or mortality.
What was studied
A retrospective comparative cohort of 200 actively bleeding trauma patients (2023-2025), 100 managed with ROTEM guidance and 100 with conventional coagulation tests.
Key findings
- Lower FFP use with ROTEM (aIRR 0.36, 95% CI 0.24-0.55)
- Higher cryoprecipitate use (aIRR 1.92, 95% CI 1.40-2.66)
- Shorter ICU stay
- No difference in adjusted RBC or platelet use
- No significant differences in transfusion complications or in-hospital mortality
Clinical relevance
Suggests ROTEM may shift component use toward fibrinogen replacement, but the authors caution against inferring reduced bleeding or RBC needs; prospective studies are needed.
Who should care
Limitations
Retrospective, non-randomised design with low RBC exposure, limiting applicability to massive haemorrhage.
ROTEM guidance was linked to more targeted plasma and cryoprecipitate use in trauma bleeding.
This is an AI-generated summary of the published abstract, not a clinical recommendation. It may not reflect the full text or subsequent updates — verify against the original source before acting on it.
Abstract
Background and objectives
Effective transfusion management is essential in trauma patients with active bleeding. In this study, we aimed to evaluate the association between point-of-care rotational thromboelastometry (ROTEM)-guided management, blood-component utilization, and clinical outcomes.
Materials and methods
We conducted a retrospective comparative cohort study of 200 trauma patients with active bleeding admitted between October 2023 and March 2025. One-hundred patients received ROTEM-guided management and 100 were managed using conventional coagulation tests. Blood-component utilization during the first 24 h and clinical outcomes were analyzed using multivariable models adjusted for relevant baseline variables.
Results
ROTEM-guided management was associated with lower fresh frozen plasma utilization (adjusted incidence rate ratio [aIRR] 0.36, 95% confidence interval [CI]: 0.24-0.55), higher cryoprecipitate utilization (aIRR 1.92, 95% CI: 1.40-2.66), and shorter intensive care unit (ICU) stay. Adjusted red blood cell (RBC) and platelet utilization did not differ between groups. Maximum clot firmness in the fibrin-based thromboelastometry assay correlated strongly with fibrinogen concentration, and clot formation time in the extrinsically activated thromboelastometry assay correlated inversely with platelet count. Differences in transfusion-related complications and in-hospital mortality were not statistically significant.
Conclusion
ROTEM-guided management was associated with lower plasma utilization, higher cryoprecipitate utilization, and shorter ICU stay. Given the retrospective, non-randomized design and low RBC exposure, these findings should not be interpreted as evidence that ROTEM reduced bleeding severity or RBC requirements, particularly in massive-transfusion populations. Prospective studies in trauma patients with massive hemorrhage are required to evaluate the utility of ROTEM in guiding specific hemostatic blood-product transfusions.
DOI
10.1111/vox.70378
PMID
42778196
Research metadata (titles, abstracts, authors, publication dates) is sourced from Europe PMC, which aggregates content from PubMed/MEDLINE, PubMed Central, and other providers under the U.S. National Library of Medicine (NLM/NCBI). NLM does not claim copyright on abstracts; the original journal publishers or authors may hold rights to the full articles. AI-generated summaries are derived only from the abstract, never the full text, and are always labeled as AI-generated.
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