Peculiar whole blood rotation thromboelastometry (Rotem) profile in 40 sideropenic anaemia patients

Luca Spiezia; Claudia Radu; Paolo Marchioro; Diana Bertini; Valeria Rossetto; Monica Castelli; Antonio Pagnan; Benny Sørensen; Paolo Simioni

doi:10.1160/TH08-04-0243

Thrombosis and Haemostasis, Table of Contents

Thromb Haemost 2008; 100(06): 1106-1110
DOI: 10.1160/TH08-04-0243

Blood Coagulation, Fibrinolysis and Cellular Haemostasis

Schattauer GmbH

Peculiar whole blood rotation thromboelastometry (Rotem) profile in 40 sideropenic anaemia patients

Luca Spiezia

¹Department of Cardiac, Thoracic, and Vascular Sciences, 2^nd Chair of Internal Medicine, University of Padua Medical School, Padua, Italy

,

Claudia Radu

¹Department of Cardiac, Thoracic, and Vascular Sciences, 2^nd Chair of Internal Medicine, University of Padua Medical School, Padua, Italy

,

Paolo Marchioro

¹Department of Cardiac, Thoracic, and Vascular Sciences, 2^nd Chair of Internal Medicine, University of Padua Medical School, Padua, Italy

,

Diana Bertini

¹Department of Cardiac, Thoracic, and Vascular Sciences, 2^nd Chair of Internal Medicine, University of Padua Medical School, Padua, Italy

,

Valeria Rossetto

¹Department of Cardiac, Thoracic, and Vascular Sciences, 2^nd Chair of Internal Medicine, University of Padua Medical School, Padua, Italy

,

Monica Castelli

¹Department of Cardiac, Thoracic, and Vascular Sciences, 2^nd Chair of Internal Medicine, University of Padua Medical School, Padua, Italy

,

Antonio Pagnan

¹Department of Cardiac, Thoracic, and Vascular Sciences, 2^nd Chair of Internal Medicine, University of Padua Medical School, Padua, Italy

,

Benny Sørensen

²Center for Haemostasis and Thrombosis, Guy’s and St. Thomas NHS Foundation Trust & King’s College London School of Medicine, London, UK

,

Paolo Simioni

¹Department of Cardiac, Thoracic, and Vascular Sciences, 2^nd Chair of Internal Medicine, University of Padua Medical School, Padua, Italy

› Author Affiliations

Abstract

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Summary

The ROtation ThromboElastoMetry analyser (ROTEM^®, Pentapharm, Munich, Germany) is useful for studying whole blood (WB) clot formation and lysis.Reduction of haematocrit (HCT) has been reported to influence traditional thromboelastography parameters without compromising “in vitro” blood coagulation. We performed this case-control study to evaluate ROTEM profiles in sideropenic anaemia patients with different degrees of reduction of HCT levels. Forty consecutively referred patients with sideropenic anaemia were enrolled. A group of 40 healthy age and gender matched subjects acted as a control. The influence of HCT on ROTEM was assessed in the study population and in a model of artificially reconstituted blood with modified HCT values. Cases presented significantly increased levels of maximum clot firmness (MCF) as compared to controls (p<0.001) mimicking a sort of “hypercoagulable profile”. How-ever, thrombin generation tests failed to detect an increase in thrombin generation in cases as compared to controls. A statistically significant inverse linear correlation between HCT and MCF (p<0.0001) was found.In addition,ROTEM profiles following “in vitro” manipulation of HCT confirmed the inverse linear correlation between HCT and MCF found in the study population. In conclusion, the increased clot firmness found by ROTEM in anaemic patients is likely to be related to the method in itself rather than representing a marker of hypercoagulability “in vivo”.Since ROTEM is widely used by anaesthesiologists when deciding the optimisation of products supplementation during surgery,attention should be paid in the case of anaemic patients taking depending on the peculiar thrombo-elastography profile found.

Keywords

Sideropenic anaemia - hypercoagulability - thromboelastometry - replacement therapy

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