cath hurn: teg/rotem in the real world
DESCRIPTION
Hurn talks us through thrombelastography on the front line.TRANSCRIPT
TEG in the real world
Know your weapons
Catherine Hurn SMACC 2013
3-4 points take away…
Some new vocabulary
As for TEGwhat it doeswhat it might doand what it doesn’t do
Vocabulary
ATC
ACoTS
TICTEG
ROTEM
ETIC
Vocabulary
ATC
ACoTS
TIC
ETIC
Acute traumatic coagulopathy
Trauma induced coagulopthy
Early trauma induced….
Acute coagulopathy of traumatic shock
Coagulopathy definition
1.5 times normal
INR 1.5, aPTT 60
INR 1.2
Brohi 2010
Maybe we just need another test…
Potential roles for TEG
1. Early diagnosis of coagulopathy2. Indicator of prognosis3. Guiding blood transfusion
1. Early diagnosis of coagulopathyATC characterized by reduced clot strength
2. Indicator of patient outcomes3 x more likely to receive transfusion70% required a MT
3. Guiding blood transfusion
Fig 1 Algorithm for goal-directed massive transfusion. The transfusion algorithm relies on thrombelastography (TEG) tracing variables to direct blood component therapy. <ce:italic> r-TEG,</ce:italic> Rapid TEG; <ce:italic> ACT,</ce:italic> acti...
Michael Pezold , Ernest E. Moore , Max Wohlauer , Angela Sauaia , Eduardo Gonzalez , Anirban Banerjee , Christophe...
Viscoelastic clot strength predicts coagulation-related mortality within 15 minutes
Surgery Volume 151, Issue 1 2012 48 - 54
http://dx.doi.org/10.1016/j.surg.2011.06.023
rTEG trace
Potential roles for TEG
1. Early diagnosis of coagulopathy2. Revealing patient prognosis3. Guiding blood transfusion4. Assess Dabigatran5. Assess risk for PE
In the real world…
ISSUES
TrickySmall cohortDud test results
Really POC?