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Semin Thromb Hemost 2021; 47(07): 815-823
DOI: 10.1055/s-0041-1726372
Review Article

ROTEM Testing for Direct Oral Anticoagulants

Barbora Korpallová
1   Department of Internal Medicine I, Jessenius Faculty of Medicine in Martin, Comenius University in Bratislava, Martin, Slovak Republic
,
Matej Samoš
1   Department of Internal Medicine I, Jessenius Faculty of Medicine in Martin, Comenius University in Bratislava, Martin, Slovak Republic
,
Tomáš Bolek
1   Department of Internal Medicine I, Jessenius Faculty of Medicine in Martin, Comenius University in Bratislava, Martin, Slovak Republic
,
Linda Kühnelová
1   Department of Internal Medicine I, Jessenius Faculty of Medicine in Martin, Comenius University in Bratislava, Martin, Slovak Republic
,
Ingrid Škorňová
2   Department of Hematology and Blood Transfusion, National Centre of Hemostasis and Thrombosis, Jessenius Faculty of Medicine in Martin, Comenius University in Bratislava, Martin, Slovak Republic
,
Peter Kubisz
2   Department of Hematology and Blood Transfusion, National Centre of Hemostasis and Thrombosis, Jessenius Faculty of Medicine in Martin, Comenius University in Bratislava, Martin, Slovak Republic
,
Ján Staško
2   Department of Hematology and Blood Transfusion, National Centre of Hemostasis and Thrombosis, Jessenius Faculty of Medicine in Martin, Comenius University in Bratislava, Martin, Slovak Republic
,
Marián Mokáň
1   Department of Internal Medicine I, Jessenius Faculty of Medicine in Martin, Comenius University in Bratislava, Martin, Slovak Republic
› Author Affiliations Funding This study was supported by project of Slovak Research and Development Agency (APVV) 16-0020 and by research project of Research Agency of Slovak Ministry of Education, Science and Sports (VEGA) 1/0090/20.
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Abstract

Direct oral anticoagulants (DOACs) are increasingly used worldwide for the prevention of stroke in patients with atrial fibrillation and to prevent or treat venous thromboembolism. In situations such as serious bleeding, the need for urgent surgery/intervention or the management of a thromboembolic event, the laboratory measurement of DOACs levels or anticoagulant activity may be required. Rotational thromboelastometry (ROTEM) is a viscoelastic hemostatic assay (VHA) which has been used in emergencies (trauma and obstetrics), and surgical procedures (cardiac surgery and liver transplants), but experience with this assay in DOACs-treated patients is still limited. This article reviews the use of ROTEM in the setting of DOACs therapy, focusing on DOACs-associated bleeding and the use of this VHA for the management of reversal strategies for DOACs-associated anticoagulation.

Keywords

thromboelastometry - ROTEM - direct oral anticoagulants - bleeding - DOACs

Ethical Approval

This research was conducted according to ethical standards. Formal approval is not needed for this type of study.




Publication History

Article published online:
15 June 2021

© 2021. Thieme. All rights reserved.

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