Hematology and Oncology Book

Coagulopathy

  • Thromboelastography

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Thromboelastography

Aka: Thromboelastography, Viscoelastic Assay, Rotational Thromboelastography, ROTEM, TEG, Viscoelastic Substances, Thromboelastography Panel
  1. Indications
    1. Massive Hemorrhage related transfusions
      1. May assist in determining ratio of Red Blood Cell Transfusions to Fresh Frozen Plasma and Platelet Transfusion
  2. Mechanism
    1. Whole blood assay of a blood's ability to clot based on viscoelastic blood properties
    2. As blood clot forms, analyzer detects resistance over time
      1. Analyzer plots measurized resistance over time in form of a graph
      2. Typically graph is plotted over a 20-30 minute period until maximal clot firmness
  3. Interpretation
    1. Abnormal Clotting Time
      1. In early trauma Coagulopathy, often related to plasma related deficiencies
      2. In later trauma Coagulopathy, Fibrinogen deficiency may be treated with Cryoprecipitate or Fibrinogen
    2. Poor maximal clot firmness (poor maximal amplitude)
      1. Consider Platelet Transfusion
    3. Hyperfibrinolysis
      1. Typically assumed as a part of early trauma Coagulopathy, and Tranexamic Acid is given empirically
      2. May appear as abnormal clot breakdown over time (typically subtle in graph)
  4. Labs: Bedside Viscoelastic Assay
    1. Thromboelastography (TEG)
    2. Rotational Thromboelastography (ROTEM)
  5. Resources
    1. Shaydakov, Sigmon, Blebea (2019) Stat Pearls
      1. https://www.ncbi.nlm.nih.gov/books/NBK537061/
  6. References
    1. Swaminathan and Hicks in Herbert (2020) EM:Rap 20(7): 1-2

Viscoelastic Substances (C2350510)

Definition (MSH) Substances that display the physical properties of ELASTICITY and VISCOSITY. The dual-nature of these substances causes them to resist applied forces in a time-dependent manner.
Concepts Chemical Viewed Functionally (T120)
MSH D055682
English Viscoelastic Substances, Substances, Viscoelastic
Spanish Sustancias Viscoelásticas
French Substances viscoélastiques, Matières visco-élastiques, Matières viscoélastiques, Substances visco-élastiques
Italian Sostanze viscoelastiche
Russian ВЯЗКОЭЛАСТИЧНЫЕ ВЕЩЕСТВА, VIAZKOELASTICHNYE VESHCHESTVA, ВЯЗКОУПРУГИЕ ВЕЩЕСТВА, VIAZKOUPRUGIE VESHCHESTVA
German Viskoelastische Substanzen
Portuguese Substâncias Viscoelásticas, Agentes Viscoelásticos
Swedish Viskoelastiska substanser
Czech viskoelastické látky
Polish Substancje wiskoelastyczne, Roztwory wiskoelastyczne, Pianki wiskoelastyczne
Japanese 粘弾性溶液, 粘弾性物質, 粘弾性フォーム
Sources
Derived from the NIH UMLS (Unified Medical Language System)


Thromboelastography panel (C3258239)

Concepts Laboratory Procedure (T059)
LNC LP133932-6, MTHU041635
English Thromboelastography panel
Sources
Derived from the NIH UMLS (Unified Medical Language System)


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