currently shows that TEG/ROTEM are beneficial in both roles. Several studies have proven TEG/ROTEM to be good predictors of the need for transfusion and MT, and of mortality.
Additionally, several of these studies compared TEG/ROTEM results with standard laboratory findings (PT/INR and aPTT) and found them to have a higher sensitivity for detecting coagulopathy on admission and an improved accuracy in predicting transfusion, MT, and mortality.
TEG/ROTEM results are available to the clinician running the resuscitation significantly quicker than traditional laboratory measures of coagulopathy, with initial results available within 5 minutes.
When used in ongoing resuscitation or as part of an MTP, TEG/ROTEM was associated with shorter time to first transfusion, higher FFPto-PRBC ratios, and increased platelet transfusion.
Effect of TEG/ROTEM use on mortality is unclear, but some evidence suggests a survival benefit. In a study of trauma patients, ROTEM-guided resuscitation resulted in mortality significantly less than that predicted by the trauma score–injury severity score, or TRISS (24.4% vs 33.7%; P 5 .032). This survival benefit was even more dramatic after excluding patients with isolated TBI (14% vs 27.8%; P 5 .0018).
Another study of patients requiring MT treated before and after initiation of MTP with TEG found that MTP with TEG guidance was associated with a significant improvement in 30-day (20.4% vs 31.5%; P 5 .0002) and 90-day mortality (22.4% vs 34.6%; P