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Anästhesiol Intensivmed Notfallmed Schmerzther 2018; 53(06): 412-424
DOI: 10.1055/s-0043-107755
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CME-Fortbildung
Georg Thieme Verlag KG Stuttgart · New York

Point of Care 2.0: Gerinnungsdiagnostik mit ROTEM® sigma und TEG® 6s

Point of Care 2.0: Coagulation Monitoring Using Rotem® Sigma and Teg® 6S
Christian Friedrich Weber
,
Kai Zacharowski
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Publication History

Publication Date:
26 June 2018 (online)

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Zusammenfassung

TEG® 6s und ROTEM® sigma sind die neueste Generation von 2 häufig perioperativ eingesetzten Point-of-Care-Methoden zur Gerinnungsdiagnostik. Sie basieren auf Systemen zur automatischen Probenvorbereitung und -analyse mit Einweg-Testkassetten – personal- und zeitintensives Pipettieren entfällt größtenteils. Dieser Beitrag beschreibt die Testprinzipien und diskutiert Vor- und Nachteile bei der Integration der Methoden in den klinischen Alltag.

Abstract

New-generation methods for point of care based coagulation monitoring enable fully automated viscoelastic analyses for the assessment of particular parts of hemostasis. Contrary to the measuring techniques of former models, the viscoelastic ROTEM® sigma and TEG® 6s analyses are performed in single-use test cartridges without time- and personnel-intensive pre-analytical procedures. This review highlights methodical strengths and limitations of the devices and meets concerns associated with their integration in routine clinical practice.

Kernaussagen

  • ROTEM sigma und TEG 6s ermöglichen automatisierte viskoelastische Diagnostik mit minimalem Personalaufwand.

  • Die Ergebnisdarstellung der Vollautomaten ähnelt der der Vorgängermodelle.

  • Nationale und internationale Leitlinien und Handlungsempfehlungen empfehlen den Einsatz viskoelastischer Diagnostik beim Blutungsmanagement mit unterschiedlich hohen Empfehlungsgraden.

  • Interne Qualitätskontrollen müssen wöchentlich erfolgen.

  • Es existiert keine Publikation zur Vergleichbarkeit der Ergebnisse von ROTEM sigma mit den Ergebnissen seiner Vorgängerversionen.

  • Es existieren keine mit den Vollautomaten evaluierten Hämotherapie-Algorithmen.

  • Für die Vorgängermodelle entwickelte Hämotherapie-Algorithmen können nicht unkritisch auf die Vollautomaten übertragen werden.

  • Das ROTEM sigma ermöglicht Aussagen über die Hämostase heparinisierter Patienten.

  • Es existiert kein TEG 6s-Test zur Diagnose eines „extrinsischen Faktorendefizits“ und damit zur Indikation von PPSB.

Schlüsselwörter

ROTEM® sigma - TEG® 6s - viskoelastische Gerinnungsdiagnostik - Gerinnungsmanagement - Point-of-Care-Gerinnungsdiagnostik

Key words

ROTEM® sigma - TEG® 6s - viscoelastic coagulation monitoring - coagulation management - point of care diagnostic of hemostasis
 

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