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TEG in the Real World: Guiding Transfusion and Predicting Outcomes

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SMACC Conference
SMACC Conference

Hurn talks us through thrombelastography on the front line.

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TEG in the real world Know your weapons Catherine Hurn SMACC 2013
3-4 points take away… Some new vocabulary As for TEG what it does what it might do and what it doesn’t do
Vocabulary ATC ACoTS TICTEG ROTEM ETIC
Vocabulary ATC ACoTS TIC ETIC Acute traumatic coagulopathy Trauma induced coagulopthy Early trauma induced…. Acute coagulopathy of traumatic shock
Coagulopathy definition 1.5 times normal INR 1.5, aPTT 60 INR 1.2
Brohi 2010
Maybe we just need another test…
Potential roles for TEG 1. Early diagnosis of coagulopathy 2. Indicator of prognosis 3. Guiding blood transfusion
1. Early diagnosis of coagulopathy ATC characterized by reduced clot strength
2. Indicator of patient outcomes 3 x more likely to receive transfusion 70% required a MT
3. Guiding blood transfusion
Fig 1 Algorithm for goal-directed massive transfusion. The transfusion algorithm relies on thrombelastography (TEG) tracing variables to direct blood component therapy. <ce:italic> r-TEG,</ce:italic> Rapid TEG; <ce:italic> ACT,</ce:italic> acti... Michael Pezold , Ernest E. Moore , Max Wohlauer , Angela Sauaia , Eduardo Gonzalez , Anirban Banerjee , Christophe... Viscoelastic clot strength predicts coagulation-related mortality within 15 minutes Surgery Volume 151, Issue 1 2012 48 - 54 http://dx.doi.org/10.1016/j.surg.2011.06.023
rTEG trace
Potential roles for TEG 1. Early diagnosis of coagulopathy 2. Revealing patient prognosis 3. Guiding blood transfusion 4. Assess Dabigatran 5. Assess risk for PE
In the real world…
ISSUES Tricky Small cohort Dud test results Really POC?
TEG in the Real World: Guiding Transfusion and Predicting Outcomes
TEG in the Real World: Guiding Transfusion and Predicting Outcomes

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