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HelpTest Code ROTEMTRAUMA ROTEM Main Lab: Trauma Panel
Clinical Information
The EXTEM and FIBTEM panel is typically used in trauma and massive hemorrhage settings for rapid diagnosis of coagulopathies. INTEM is not run in this panel.
Reflex testing with APTEM is performed when maximum lysis in EXTEM is >15%. APTEM should be compared to EXTEM to identify hyperfibrinolysis.
Profile Information
| Test Code | Reporting Name | Available Separately | Always Reported |
|---|---|---|---|
| EXTEM | CT D | No | No |
| CFT D | No | No | |
| Alpha Angle D | No | No | |
| A10 D | No | No | |
| A20 D | No | No | |
| MCF D | No | No | |
| ML D | No | No | |
| LI30 D | No | No | |
| FIBTEM | CT D | No | No |
| CFT D | No | No | |
| Alpha Angle D | No | No | |
| A10 D | No | No | |
| A20 D | No | No | |
| MCF D | No | No | |
| ML D | No | No | |
| LI30 D | No | No |
Specimen Required
Preferred Container/Tube: 3.2% Citrate Blue Top - 2.7 mL
Specimen Volume: 2.7 mL
Acceptable Container/Tube: 3.2% Citrate Blue Top - 1.8 mL
Specimen Volume: 1.8 mL
Specimen Collection Information
Blue top tube must be completely filled; mix gently by inversion.
Do not shake or roll tubes containing patient blood.
Specimens should be kept at room temperature and walked directly to the laboratory for testing.
DO NOT transport via pneumatic tube system
Care should be taken to avoid contamination from IV fluids, espeically lines delivering anticoagulants.
Specimen Stability Information
Ambient:
Whole blood: 4 hours
Rejection Due To
- Ambient specimens >4 hours old
- Clotted specimens
- Underfilled or overfilled tube
- Samples delivered by pneumatic tube system
Testing Algorithm
If the Extem ML% >15%, the Aptem will be performed.
Reflex Tests
| Test Code | Reporting Name | Available Separately | Always Reported |
|---|---|---|---|
| APTEM | CT D | No | No |
| CFT D | No | No | |
| Alpha Angle D | No | No | |
| A10 D | No | No | |
| A20 D | No | No | |
| MCF D | No | No | |
| ML D | No | No | |
| LI30 D | No | No |
Reference Values
EXTEM CT: 43-82sec
EXTEM CFT: 48-127 sec
EXTEM ALPHA: 65-80 degree
EXTEM A20: 50-70 mm
EXTEM MCF: 52-70 mm
FIBTEM A20: 7-21 mm
FIBTEM MCF: 7-21 mm
Reference ranges are not available for all ROTEM components unless otherwise noted: Interpretation of ROTEM results must include all available parameters, patient clinical context and current therapy.
Interpretation of APTEM results (fibrinolytic activity) must include correlation between the EXTEM and APTEM data. All results should be interpreted carefully based on patient clinical context and current therapy.
Interpretation
Cautions
Limitations of ROTEM thromboelastometry Platelet inhibitors:
- No detection of Aspirin®
- No detection of clopidogrel/Plavix®
- No detection of von Willebrand syndrome
- Poor sensitivity to Reopro®
Anticoagulants:
- Poor sensitivity to low molecular weight heparin, Orgaran® and pentasaccharide
- Poor sensitivity to oral anticoagulants (coumarins: Warfarin®, etc.)
Not intended to be used to identify mild platelet deficiencies or platelet coagulation abnormalities.
Method Description
Rotational Viscoelastic Testing- Rotem Delta: The patented ROTEM technology is based on a fixed cylindrical cup and a permanently oscillating vertical axis.
The axis is supported by a high precision ball bearing and oscillates to the left and to the right through an angle of 4.75°.
Performing Lab
Clinical Lab UH
Day(s) Performed
Monday through Sunday
Report Available
Same day/1 day
Reporting Name
EXTEM D, FIBTEM D, APTEM D
CPT Code Information
85396
LOINC Code Information
52776-2
52771-3
52781-2
52787-9
52773-9
52770-5
52783-8
52786-1
52775-4
52772-1
52782-0
52788-7
100346-6
100347-4
52780-4
52774-7
52769-7
52779-6
52785-3