Thromboelastography for general surgery

Abstract

Conventional coagulation tests evaluate the time in which the coagulation factors are activated in the blood plasma, which lacks cellular components such as enzymes and platelets that are involved in the development of hemostasis. Thromboelastography (TEG) performs an in vitro analysis of the relationship between platelets, enzymes, fibrinogen, and other coagulation elements in an integral way; reason why it is used more frequently in cardiac surgeries, transplants, and surgeries of arteriovenous malformations, where the expected blood loss is greater than 40% of the circulating blood volume. The inclusion of TEG in the pre-anesthetic evaluation allows evaluating platelet activity in patients who use antiplatelets therapy, such as clopidogrel or acetylsalicylic acid, through platelet mapping (Platelet Mapping®). When bleeding occurs in the trans-anesthetic period, TEG specifically identifies the type of treatment necessary to improve coagulation or transfusion of formed blood elements. The TEG allows more sophisticated transfusion therapy protocols to be carried out, which implies a decrease in complications associated with polytransfusion and a reduction in costs, so these benefits justify the routine use of TEG for any general surgery.