Thromboelastography (trademarked as TEG) • Graphical representation of the fibrin polymerization process • Point-of-care anti-coagulation monitoring to aid in determining if transfusion of blood products is needed (its value lies in the ability to determine the need for specific blood products) • Has been studied compared to routine transfusion algorithms and has been shown to reduce number of transfusions required without compromising outcomes (primarily in cardiac surgical patients) R (reaction time) • Time elapsed until first measurable clot is formed • If ↑ → clotting factor deficiency → give FFP K (K time) • Time elapsed until clot reaches a fixed strength • If ↑ → fibrinogen deficiency → give cryoprecipitate α angle • Speed of fibrin accumulation • If ↓ → fibrinogen deficiency → give cryoprecipitate MA (maximum amplitude) • Highest vertical amplitude • If ↓ → platelet deficiency → give platelets LY30 (lysis at 30 minutes) • % of amplitude reduction 30 minutes after its maximum (reflects fibrinolysis • If ↑ → excess fibrinolysis → give anti-fibrinolytics (aminocaproic acid or tranexamic acid Dr. Satya Patel @SatyaPatelMD #Thromboelastography #Thromboelastogram #TEG #interpretation #hematology
