Thromboelastography (TEG® 5000 and TEG® 6s hemostasis analyzers with TEG manager® software)

Abstract

The TEG® Hemostasis Analyzer measures the viscoelastic properties of blood in order to provide a comprehensive real-time analysis of hemostasis, from initial fibrin fiber formation, to platelet interactions, to fibrinolysis. Such insight into hemostasis not only allows for a better understanding of the biology and pathophysiology of coagulation after injury, but also has facilitated rapid site-of-care treatment for patients in a variety of clinical settings. Consequently, a number of algorithms have been developed and validated for goal-directed transfusion therapy. This chapter reviews the thromboelastography methodology and technology principles of the TEG® system and provides a comparison of the TEG® 5000 with the newer TEG® 6s Hemostasis Analyzer. An overview of key variables measured, reference ranges, reagents used, and limitations is provided, as well as guidance on the clinical interpretation of TEG® Hemostasis Analyzer results. This chapter also provides an evidence-based guide for the use of TEG® in several clinical settings including trauma, cardiac surgery, liver transplantation, and obstetrics.