Thromboelastography (TEG): Difference between revisions
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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. | ||
[[Category:Heme/Onc]] | [[Category:Trauma]][[Category:Heme/Onc]] |
Revision as of 03:41, 5 January 2015
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.