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

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Abstract
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 (pin 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.

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