⚡ Harnessing the Power of TEG & ROTEM: A Game Changer in Approaching Coagulation Care
You have probably heard these terms thrown around, but what exactly are they?
TEG and ROTEM provide an overall assessment of haemostasis and can help guide treatment and management in episodes of acute bleeding in the perioperative environment.
They are a form of Point of Care Testing (POCT) - a rapid, specific type of fluid testing (in this case coagulation) that can essentially be performed at the bedside.
🩸 TEG = Thromboelastography
🔄 ROTEM = Rotational Thromboelastometry
Benefits:
👉 Provides rapid assessment of coagulation status, allowing for timely administration of blood products
👉 Reduces the occurrence of inappropriate or unnecessary transfusion
👉 Reduces rates of return to theatre for relook explorations
👉 Can indicate inadequate heparin reversal or heparin rebound
Limitations:
🔺 Staff need to be trained in order to prepare samples and run the testing
🔺 Baseline testing is not predictive of postoperative bleeding
🔺 Not reflective of the effects of hypothermia as the test is run at 37 degrees
🔺 Tracings will not indicate the presence of aspirin or clopidogrel in a blood sample
🔺 Testing methodology is not standardised, making result comparison between institutions difficult
Both tests are similar in that they provide a continuous measurement of the visco-elastic properties of whole blood throughout the various phases of coagulation.
However! They must not be confused when interpreting results and determining treatment - their results and reference ranges are different!
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Ref:
Srivastava, A., Kelleher, A. (2013) Point-of-care coagulation testing. Continuing Education in Anaesthesia Critical Care & Pain, Volume 13(1) Pp12–16, https://doi.org/10.1093/bjaceaccp/mks049
Wells, M., Raja, M., Rahman, S. (2022) Point of Care Viscoelastic testing. British Journal of Anaesthesia. Volume 22 (11) Pp 416-423 DOI: 10.1016/j.bjae.2022.07.003
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