While attending the American Society for Clinical Laboratory Science (ASCLS)-Michigan annual meeting in Kalamazoo, I met Beth Friedt, MSA, MT (ASCP), Administrative Director of the Clinical Laboratory at Hurley Medical Center, Flint, Michigan. She asked if thromboelastography (TEG) or thromboelastometry (TEM) has been used to measure low molecular weight heparin (LMWH) therapy. I knew of no instance where it was being used regularly for this purpose, nor do I know of a therapeutic range, however, I found several publications on the subject through PubMed, including the 2000 AJCP article attached below. Of course, the standard method for LMWH concentration the chromogenic anti-Xa heparin assay.
Apr 29 2014
Comments (1)Anticoagulant Therapy
LMWH could affect the R-time in TEG only when unstimulated/n
LMWH could affect the R-time in TEG only when unstimulated/native assay is used (as in the AJCP publication). The standard kaolin-initiated TEG assay had less impressive sensitivity;
Comparison of ACT, TEG®, and anti-Xa in detecting decline of therapeutic enoxaparin concentration (abstract):