Thromboelastography (TEG): Difference between revisions
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*Propagation (α-Angle) | *Propagation (α-Angle) | ||
**Thrombin burst | **Thrombin burst | ||
*Clot strength (MA) | |||
**Strongest point of fibrin clot | |||
*Clot stability (LY 30%) | |||
**Degree of fibrinolysis | |||
==Normal Values== | ==Normal Values== | ||
| Line 14: | Line 18: | ||
*K: 1-4 min | *K: 1-4 min | ||
*α-Angle: 47-74° | *α-Angle: 47-74° | ||
*MA: 55-73mm | |||
*LY 30%: 0-8% | |||
==Abnormal Values== | ==Abnormal Values== | ||
*Prolonged R | *Prolonged R | ||
**Factor deficiency | **Factor deficiency (ie hemophilia) | ||
**Treat with FFP | **Treat with FFP or protamine | ||
*Prolonged K/Reduced α-Angle | *Prolonged K/Reduced α-Angle | ||
** | **Fibrinogen deficiency (ie DIC) | ||
**Treat with cryoprecipitate | **Treat with cryoprecipitate | ||
* | *Reduced MA | ||
**Thrombocytopenia, platelet dysfunction ( | **Thrombocytopenia, platelet dysfunction (ie patient on clopidogrel) | ||
**Treat with platelets or DDAVP | **Treat with platelets or DDAVP | ||
*Elevated LY 30% | *Elevated LY 30% | ||
** | **Rapid clot lysis (ie tPA given) | ||
**Treat with TXA | **Treat with TXA | ||
== | ==TEG Diagram== | ||
[[File:TEG-Illustration.png|thumb|Normal thromboelastogram]] | |||
==See Also== | ==See Also== | ||
[[Coagulopathy (Main)]] | |||
[[Transfusions]] | |||
==External Links== | ==External Links== | ||
http://marylandccproject.org/core-content/utility-teg-blood-component-therapy/ | |||
==Sources== | ==Sources== | ||
<references/> | <references/> | ||
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. | 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. | ||
Revision as of 03:10, 30 June 2014
Background
Tromboelastogram (TEG or 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
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.