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THROMBOELASTOGRAPHY

thromboelastography

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thromboelastography principle and interpetation

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THROMBOELASTOGRAPHY

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TEG Principle

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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

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TEG Parameters

r time ↑ by

Factor deficiency Anti-coagulation Severe

hypofibrinogenaemia Severe thrombocytopenia

r time ↓ by

Hypercoagulability syndromes

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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

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TEG Parameters

k time ↑ or angle ↓by

Factor deficiency Hypofibrinogenaemia Thrombocytopenia

k time↓ or angle ↑ by

Hypercoagulability state

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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

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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

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Factor Deficiency

Heparin effect

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Thrombocytopenia

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Fibrinolysis

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Hypercoagulable

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Severe Coagulopathy

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Heparin Effect