From Hypercoagulability to Hypocoagulability: Dynamic ROTEM Phenotypes and Outcomes in Sepsis and Septic Shock

Background/Objectives: Sepsis is characterized by profound and dynamic alterations of haemostasis, ranging from hypercoagulability and fibrinolysis shutdown to mixed patterns, hypocoagulability, and overt disseminated intravascular coagulation. Conventional coagulation tests provide only a partial representation of these changes. Rotational thromboelastometry (ROTEM) offers a whole-blood, dynamic assessment of clot initiation, propagation, firmness, and lysis, potentially allowing for more accurate haemostatic phenotyping.