From Meg Hardin. George, The surgical services in our hospital are requesting that we look into purchasing the Thromboelastograph (TEG) or Rotational Thromboelastometry System (ROTEM) in order to decrease blood utilization. TEG representatives tell surgical services that they can receive results with in 2 minutes of the blood being placed on the analyzer. I know nothing (except what I read) about these analyzers and was wondering if any of your readers who use TEG or ROTEM could give me some information? I thank everyone in advance for their time with this question.
Hi, Meg, I hope we get some good responses. I have no experience with the ROTEM, though many Fritsma Factor participants use them. The TEG has been around since 1948, is a point of care analyzer that provides clotting results within two minutes of initiation as claimed, though the complete TEG tracing may require as much as 30 minutes, the trailing portion illustrating fibrinolysis. Most TEGs and ROTEMs are managed by operating room personnel and interpreted by anesthetists and anesthesiologists as a means for monitoring anticoagulant therapy, fibrinolysis, and for detecting disseminated intravascular coagulation.
An article, Gorlinger K, Fries D, Dirkmann D, et al. Reduction of FFP requirements by perioperative POC coagulation management with early calculated goal-directed therapy. Transfus Med Hemother 2012; 29: 104–13. illustrates how TEG may be used prior to surgery and in response to trauma to reduce therapeutic red blood cell and plasma volumes.