PMC9132692_01
Initial and subsequent rotational thromboelastometry (ROTEM) parameters for a patient with amniotic fluid embolism. (a) ROTEM obtained just after ECMO initiation demonstrates extremely prolonged clotting time, poor clot amplitude, and fibrinolysis. (b) ROTEM obtained after additional FFP and cryoprecipitate showing dramatic improvement with normal EXTEM clotting time, mildly prolonged INTEM clotting time, normal FIBTEM clot amplitude, and EXTEM/INTEM clot amplitude just below the normal range.
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fig1
She was not given heparin due to ROTEM with prolonged clotting time and very low clot amplitude with evidence of fibrinolysis (Figure 1).