September 2021 Quick Question: TEG

September 2021 Quick Question: TEG
Sep 30, 2021 12:05pm

Our September 2021 Quick Question attracted only 14 responses, perhaps reflecting the minimal communication between the central laboratory and the anesthesiology service in most operating rooms. Our question was "What is the favorite near-patient viscoelastic test of US anesthesiologists?" Here are your answers:

  1. Rotational thromboelastometry [ROTEM ]: 14% [2]
  2. Resonance sonorheometry [Quantra]: 7% [1]
  3. Activated clotting time [ACT ]: 0%
  4. Thromboelastography [TEG ]: 79% [11]

This topic arose when the anesthesiology service at a nearby facility requested a presentation on thromboelastography. We've found that the ROTEM is popular in Europe whereas the TEG is used in North American operating rooms and more recently in emergency departments, mainly to manage heparin and blood component therapy. The Quantra is a recent entry in the viscoelastometry science from HemoSonics, and, while not on our list, the time-honored Sonoclot has a worldwide distribution. The near-patient ACT , while employed in most cardiac surgery suites to monitor hypertherapeutic heparin levels, is a modification of the long-obsolete Lee-White coagulation time, not a global viscoestometry assay.

2 Comments

Our September 2021 Quick Question attracted only 14 responses, perhaps reflecting the minimal communication between the central laboratory and the anesthesiology service in most operating rooms. Our question was "What is the favorite near-patient viscoelastic test of US anesthesiologists?" Here are your answers:

  1. Rotational thromboelastometry [ROTEM ]: 14% [2]
  2. Resonance sonorheometry [Quantra]: 7% [1]
  3. Activated clotting time [ACT ]: 0%
  4. Thromboelastography [TEG ]: 79% [11]

This topic arose when the anesthesiology service at a nearby facility requested a presentation on thromboelastography. We've found that the ROTEM is popular in Europe whereas the TEG is used in North American operating rooms and more recently in emergency departments, mainly to manage heparin and blood component therapy. The Quantra is a recent entry in the viscoelastometry science from HemoSonics, and, while not on our list, the time-honored Sonoclot has a worldwide distribution. The near-patient ACT , while employed in most cardiac surgery suites to monitor hypertherapeutic heparin levels, is a modification of the long-obsolete Lee-White coagulation time, not a global viscoestometry assay.

By Dr Paul Riley
Oct 20, 2021 10:47am
Hi George, I have never heard of a US lab where the Sonoclot was used, and had to Google to figure out what it was. Do you know many labs with that instrument?
From George: I know of several US labs that continue to use the Sonoclot, and I know that it has been marketed outside of the US. I don't have specifics, so please watch for additional comments.
By George Fritsma
Oct 31, 2021 7:52pm
Paul, I spoke with Jon Henderson, Sienco president, Boulder, CO, USA. Sienco, founded by engineer Sanford [Sandy] Simons in ~1964, continues to market the Sonoclot Coagulation and Platelet Function Analyzer in the US and worldwide. Sonoclot employs a vertically oscillating disposable probe to electromechanically measure plasma viscosity as a clot develops. The tracing's appearance is sensitive to viscosity early in the clotting process and differs markedly in appearance from the TEG and ROTEM "boat." Sandy Simons, who was assigned to the Manhattan Project in 1940, developed a compact platelet aggregometer in 1964 but began in 1975 to develop, improve, and market the Sonoclot.

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