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thromboelastography principle and interpetation
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THROMBOELASTOGRAPHY
TEG Principle
TEG Parameters
r time
• Time from initiation of trace until the amplitude of the trace reaches 2 mm
• Corresponds to initial fibrin formation
• Functionally related to plasma clotting and inhibitor activity
TEG Parameters
r time ↑ by
Factor deficiency Anti-coagulation Severe
hypofibrinogenaemia Severe thrombocytopenia
r time ↓ by
Hypercoagulability syndromes
TEG Parameters
K time
• Time from r until amplitude reaches 20 mm
• Measure of clot formation kinetics
angle
• Measures the rapidity of fibrin polymerization
• assesses rate of clot formation
TEG Parameters
k time ↑ or angle ↓by
Factor deficiency Hypofibrinogenaemia Thrombocytopenia
k time↓ or angle ↑ by
Hypercoagulability state
TEG ParametersMaximum amplitude
• is a direct function of the maximum dynamic properties of fibrin and platelet bonding
• represents the maximum strength of the fibrin clot
• Correlates more to platelet function and to lesser extent to fibrinogen
MA ↓ by
Thrombocytopenia
Thrombocytopathy
Fibrinolysis
Hypofibrinogenemia
TEG ParametersLY30
• measures % decrease in amplitude 30 min post-MA
• gives measure of degree of fibrinolysis
• normal range < 7.5%
LY60
60 minute post-MA data
Factor Deficiency
Heparin effect
Thrombocytopenia
Fibrinolysis
Hypercoagulable
Severe Coagulopathy
Heparin Effect