How is thromboelastography (TEG) used to monitor transfusions?

Updated: Apr 16, 2019
  • Author: Linda L Maerz, MD, FACS, FCCM; Chief Editor: Emmanuel C Besa, MD  more...
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Thromboelastography (TEG) evaluates clot initiation, formation, and stability, using whole blood or plasma. TEG has been used primarily to monitor blood component therapy during surgery. Initially used in hepatic transplantation, the technique has been used during cardiac surgery as well as damage control surgery after injury. Within 30 minutes, TEG provides a representation of the sum of platelet function, coagulation proteases and inhibitors, and the fibrinolytic system. Analysis of the tracing provides a means to assess the need for blood component therapy. Modern devices substitute a computer graphic for the old-style roller drum paper tracing. Each element of the TEG tracing relates to a different aspect of clotting, as follows: the time required for clot formation underscores the need for FFP, clot strength guides platelet therapy, addition of heparinase assists in determining protamine dosage, and the degree of clot lysis determines the need for antifibrinolytic therapy. [20]

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