Thrombelastography in the surgical patient

Area of Science:

• Anesthesiology and Perioperative Medicine
• Hematology
• Surgical Sciences

Background:

• Coagulopathy is a significant risk factor for perioperative complications, including bleeding and thromboembolic events, leading to increased mortality and morbidity.
• Routine coagulation tests are the current standard but have limitations, lacking dynamic information on clot kinetics, strength, and fibrinolysis, with significant result delays.

Purpose of the Study:

• To provide an overview of thrombelastography (TEG) and thrombelastometry (ROTEM) techniques.
• To discuss the perioperative applications of TEG and ROTEM based on recent data.

Main Methods:

• Thrombelastography (TEG) and thrombelastometry (ROTEM) measure the viscoelastic properties of whole blood.
• These techniques allow dynamic assessment of clot formation, strengthening, and lysis.

Main Results:

• TEG and ROTEM provide comprehensive, real-time data on coagulation dynamics, overcoming limitations of routine tests.
• These methods are increasingly utilized in clinical practice for detecting and managing perioperative coagulopathy.

Conclusions:

• Thrombelastography and thrombelastometry are valuable tools for dynamic assessment of coagulation status in surgical patients.
• These techniques aid in guiding pro-coagulant therapy and potentially improving patient outcomes in perioperative settings.