Thromboelastography (TEG) Point-of-Care Diagnostic for Hemostasis Management

Thromboelastography is a method of assessing the coagulation status of patients. Unlike standard laboratory-based coagulation tests (eg, prothrombin time and activated partial thromboplastin time), it provides a holistic, functional perspective on the entire coagulation process; and point-of-care application provides results more quickly. Across a wide range of clinical settings, thromboelastography can be used to assess the risk of bleeding or thromboembolic events and to guide management of hemostatic equilibrium. Until recently, the principal system for performing thromboelastography was the TEG 5000 analyzer. The TEG 6s system, which consists of the TEG 6s analyzer and disposable cartridges, measures the same properties as the TEG 5000 and was recently developed to increase the ease and precision with which thromboelastography is performed. By measuring the velocity of clot formation, the strength of the clot, contributions of fibrinogen and platelets to clot strength, and the speed/extent of fibrinolysis, a comprehensive insight into the patient's coagulation status is gained. Treatment can then be individualized to ensure effective coagulation management while avoiding exposure to unnecessary treatment. Subsequently, the effect of treatment can be assessed to determine whether further intervention may be required. We review the clinical use of thromboelastography in trauma, cardiovascular surgery, liver transplantation, obstetrics, congenital bleeding disorders, and other settings. Increased uptake of thromboelastography has the potential to improve standards of patient care and to lead to health economic benefits.