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Perfusion Newswirei-Pump Quick ReferenceQuick Reference: Thromboelastography (TEG)

Quick Reference: Thromboelastography (TEG)

i-Pump Quick Reference

The TEG analyzer automatically records the visco-elastic changes in a sample of whole blood, plasma or platelet-rich plasma as the sample clots, retracts and/or lyses. The resultant profile is a measure of the kinetics of clot formation and dissolution of clot quality (the ability to perform the work of coagulation). Because the TEG system monitors shear elasticity (a physical property), it is sensitive to all the interacting cellular and plasmatic components in the blood that may affect the rate or structure of a clotting sample and its breakdown. The overall profile can be qualitatively or quantitatively interpreted in terms of the hypo, normal or hypercoagulable state of the sample and the degree of lysis.

    • R or R-Time:
      (Reaction Time):        The time from when the sample is put into the TEG Analyzer
      until the first sign of clot formation (amplitude of 2 mm) is reached.
    • K or K-time: 
      The time from the R to a fixed level of clot firmness (amplitude of 20 mm) is
      reached.
    • Angle (α): 
      The rate of clot growth.
    • MA (Maximum
      Amplitude):       
       MA measures the strength of the clot.
    • G: 
      Measurement of clot firmness.
    • CI (Coagulation
      Index):       
      Describes the patient’s overall coagulation.
 


TEG
TREATMENT GUIDE


TEG
Value



Hemostasis State



Common Treatment


R
less than 4 min


Enzymatic hypercoaguIability


Anticoagulant of choice


R
between 11 – 14 min

Low
clotting factors

x 2 FFP
or 8 ml/kg


R
greater than 14 min

Very
low clotting factors

x 4 FFP
or 16 ml/kg


MA
between 46 – 54 mm

Low
platelet function

0.3


μg
/kg DDAVP


MA
between 41 – 45 mm

Very
low platelet function

x 5
platelet units


MA
at 40 mm or less


Extremely low platelet function

x 10
platelet units


MA
greater than 73 mm


Platelet hypercoagulability


Antiplatelet therapy

R
less than 4 min and MA greater than 73


Enzymatic and platelet hypercoagulability


Antiplatelet therapy and anticoagulant of choice


Angle
less than 45°

Low
fibrinogen level

.06
u/kg Cryo

LY30
at 7.5% or greater, CI less than 1.0

Primary
fibrinolysis


Antifibrinolytic of choice

LY30
at 7.5% or greater, CI greater than 3.0


Secondary fibrinolysis


Anticoagulant of choice

LY30
less than 7.5%, CI greater than 3.0


Prothrombotic state


Anticoagulant of choice

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