Thromboelastography (TEG): Difference between revisions
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;Lack of evidence strongly suggests that these tests currently should be used ONLY FOR RESEARCH purposes in regards to trauma-induced coagulopathy.<ref>Hunt H, Stanworth S, Curry N, Woolley T, Cooper C, Ukoumunne O, Zhelev Z, Hyde C. TEG and ROTEM for diagnosing trauma‑induced coagulopathy (disorder of the clotting system) in adult trauma patients with bleeding. Cochcrane Review. 16 February 2015 http://www.cochrane.org/CD010438/INJ_teg-and-rotem-for-diagnosing-trauma-induced-coagulopathy-disorder-of-the-clotting-system-in-adult-trauma-patients-with-bleeding</ref> | |||
==Background== | ==Background== | ||
Tromboelastogram (TEG or formerly ROTEM) is used to identify acute coagulopathies in both traumatic and nontraumatic patients. This enables focused use of blood products during resuscitation. | Tromboelastogram (TEG or formerly ROTEM) is used to identify acute coagulopathies in both traumatic and nontraumatic patients. This enables focused use of blood products during resuscitation. | ||
Revision as of 03:01, 23 February 2015
- Lack of evidence strongly suggests that these tests currently should be used ONLY FOR RESEARCH purposes in regards to trauma-induced coagulopathy.[1]
Background
Tromboelastogram (TEG or formerly ROTEM) is used to identify acute coagulopathies in both traumatic and nontraumatic patients. This enables focused use of blood products during resuscitation.
Features of a TEG Curve
- Initiation (R)
- Factor VIIa and Tissue Factor
- Amplification (K)
- Thrombin and activation of platelets
- Propagation (α-Angle)
- Thrombin burst
- Clot strength (MA)
- Strongest point of fibrin clot
- Clot stability (LY 30%)
- Degree of fibrinolysis
Normal Values
- R: 4-8 min
- K: 1-4 min
- α-Angle: 47-74°
- MA: 55-73mm
- LY 30%: 0-8%
Abnormal Values
- Prolonged R
- Factor deficiency (ie hemophilia)
- Treat with FFP or protamine
- Prolonged K/Reduced α-Angle
- Fibrinogen deficiency (ie DIC)
- Treat with cryoprecipitate
- Reduced MA
- Thrombocytopenia, platelet dysfunction (ie patient on clopidogrel)
- Treat with platelets or DDAVP
- Elevated LY 30%
- Rapid clot lysis (ie tPA given)
- Treat with TXA
TEG Diagram
See Also
Coagulopathy (Main) Transfusions
External Links
http://marylandccproject.org/core-content/utility-teg-blood-component-therapy/
Sources
- ↑ Hunt H, Stanworth S, Curry N, Woolley T, Cooper C, Ukoumunne O, Zhelev Z, Hyde C. TEG and ROTEM for diagnosing trauma‑induced coagulopathy (disorder of the clotting system) in adult trauma patients with bleeding. Cochcrane Review. 16 February 2015 http://www.cochrane.org/CD010438/INJ_teg-and-rotem-for-diagnosing-trauma-induced-coagulopathy-disorder-of-the-clotting-system-in-adult-trauma-patients-with-bleeding
Walsh M, Thomas SG, Howard JC, et al. Blood component therapy in trauma guided with the utilization of the perfusionist and thromboelastography. Journal of Extra-Corporeal Technology. 2011 Sep; 43(3):162-7.