Can Anyone explain TEGs to me?

Specialties MICU

Published

Hi! On our trauma line, over the past couple of months, our docs are ordering TEGs right, left and center. Can anyone help me out with them? I have tried looking things up, but it's all mishmash to me. Also, can anyone explain to me when you would give FFP, cryo, etc. based on what the results of the TEG are?

Thank you very much in advance!!!

Specializes in Peds- ICU.

Hello,

Thromboelastogram (TEG)

Thank you for the link! Would you be able to break it down for me, when you would or wouldn't give different blood products?Thanks!

Specializes in Peds- ICU.

We had a perfusion tech who would run the test for us, Then would bring in the diagram and then the anesthesiologist would then ask for blood, platelets, or ffp, or cryo.

NORMAL TEG

TEG-21.jpg

  • R = reaction time (s); time of latency from start of test to initial fibrin formation
  • K = kinetics (s); time taken to achieve a certain level of clot strength (amplitude of 20mm)
  • alpha = angle (slope between R and K); measures the speed at which fibrin build up and cross linking takes place, hence assesses the rate of clot formation
  • TMA = time to maximum amplitude(s)
  • MA = maximum amplitude (mm); represents the ultimate strength of the fibrin clot
  • A30 or LY30 = amplitude at 30 minutes; percentage decrease in amplitude at 30 minutes post-MA and gives measure of degree of fibrinolysis
  • CLT = clot lysis time (s)

IMPORTANT PATTERNS

TEG-3.jpg

TEG AS A GUIDE TO TREATMENT

  • Increased R time => FFP
  • Decreased angle => cryopreciptate
  • Decreased MA => platelets (consider DDAVP)
  • Fibrinolysis => transexamic acid (or aprotinin)

Thanks

Adam

Specializes in CTICU.

We also use TEG to guide our antiplatelet therapy in LVAD patients - alpha or MA >70 and we increase the aspirin.

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