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Table 1 Timeline of laboratory results, ROTEM® results, and interventions in order of time when intervention or testing was initiated

From: Case report of amniotic fluid embolism coagulopathy following abortion; use of viscoelastic point-of-care analysis

Event or InterventionTime ObtainedProcessing Timea (minutes)CBCbaPTT (seconds)INRFibrinogen (milligrams/deciliter)/FIBTEM A10 (mm)EXTEM Clotting Time (CT) and A10
Pre-Op  12.1
134
    
EventDilation and evacuation completed at 08:34.
EventOngoing vaginal bleeding, episode of hypotension, return to the OR at 10:28.
Lab 110:518810.4
84
38.01.7  
Lab 213:0813210.6
93
38.52.0Fibrinogen < 25 
ROTEM® 113:30    Undetectable FIBTEM valueCT = 359 s, A10 = 16 mm
InterventionAt time of ROTEM® 1 result, initiated 3 g concentrated fibrinogen, 1 unit FFP, 1 × 5-pack platelets.
Lab 314:21729.5
53
34.41.4Fibrinogen 49 
ROTEM® 214:21    2 mm FIBTEM (low amplitude)Improvement in EXTEM.
CT = 187 s, A10 = 20 mm
InterventionAt time of ROTEM® 2 result, initiated 1 g concentrated fibrinogen, 2 units of cryoprecipitate, 3 units of FFP, 1 × 5-pack platelets, 2 g TXA.
Lab 415:47576.2
81
22.41.0Fibrinogen 255 
Intervention1 unit cryoprecipitate, 2 units red blood cells given between obtaining Lab 4 and receiving the results.
ROTEM® 316:44    13 mm FIBTEM (normal amplitude)Normal EXTEM.
CT = 60 s, A10 = 45 mm
Lab 517:01538.7
79
26.61.0Fibrinogen 243 
Intervention2 × 5-pack platelets.
 22:21348.8
141
25.31.0Fibrinogen 283 
  1. aProcessing time (minutes) reflects the time from lab collection to the full panel of labs resulting in the electronic medical record system
  2. b Hgb Platelets
  3. Complete blood count (CBC) with hemoglobin (Hgb) measured in grams/deciliter, platelets in unit × 103/μl. Activated partial thromboplastin time (aPTT), International Normalized Ratio (INR), clot amplitude at 10 min (A10), clotting time (CT), rotational thromboelastography (ROTEM®), fresh frozen plasma (FFP), tranexamic acid (TXA)