Global hemostasis testing thromboelastography: old technology, new applications.

Area of Science:

• Hematology
• Clinical Pathology

Background:

• Thromboelastography (TEG) has been used for over 60 years to assess hemostatic and fibrinolytic function.
• Technological advancements have improved TEG reliability and expanded its clinical applications beyond traditional uses in liver transplant and cardiac surgery.

Purpose of the Study:

• To review the expanded indications and applications of TEG in modern clinical practice.
• To discuss the advantages and disadvantages of TEG, including its use in specialized settings and with specific patient populations.

Main Methods:

• Review of existing literature and clinical applications of Thromboelastography (TEG).
• Discussion of TEG's utility in managing extracorporeal membrane oxygenation (ECMO), assessing bleeding disorders, and monitoring hypercoagulable states.
• Exploration of TEG platelet mapping for antiplatelet therapy monitoring and its limitations.

Main Results:

• TEG is increasingly used for managing ECMO, evaluating unclear bleeding, and assessing hypercoagulable states.
• TEG offers advantages such as whole blood analysis, rapid results, point-of-care testing, hyperfibrinolysis detection, and monitoring specific therapies.
• Limitations include variability, standardization issues, sample stability, and age-specific reference ranges in pediatrics.

Conclusions:

• Thromboelastography (TEG) is a valuable, evolving tool for assessing global hemostasis across diverse clinical scenarios.
• Despite limitations, TEG provides unique insights into hemostatic function, with potential for new applications in conditions like polycythemia and dysfibrinogenemia.