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.

直接口服抗凝剂 (DOAC) 在世界范围内越来越多地用于预防心房颤动患者的卒中以及预防或治疗静脉血栓栓塞。在严重出血、需要紧急手术/干预或血栓栓塞事件管理等情况下，可能需要对 DOAC 水平或抗凝活性进行实验室测量。旋转血栓弹力图 (ROTEM) 是一种粘弹性止血试验 (VHA)，已用于紧急情况（创伤和产科）和外科手术（心脏手术和肝移植），但在 DOACs 治疗的患者中使用该试验的经验仍然有限。本文回顾了 ROTEM 在 DOACs 治疗中的应用，