TEG and ROTEM: technology and clinical applications

Area of Science:

• Hematology
• Biomedical Engineering
• Point-of-care Diagnostics

Background:

• Thromboelastography (TEG), first described in 1948, assesses real-time viscoelastic clot strength.
• Rotational thromboelastometry (ROTEM) is an evolution of TEG technology.
• Both devices analyze a small blood sample (300 µl) under constant rotational force.

Purpose of the Study:

• To provide a comprehensive overview of TEG and ROTEM technologies.
• To highlight their application in assessing blood coagulation kinetics and clot strength.
• To discuss their integration into diagnostic and treatment algorithms for bleeding disorders.

Main Methods:

• Real-time assessment of viscoelastic clot strength using TEG and ROTEM.
• Analysis of clot formation, propagation, stabilization, and dissolution.
• Utilizing intrinsic and extrinsic activators for clot initiation.
• Employing platelet inhibitors (abciximab, cytochalasin D) to assess fibrinogen and platelet contributions.

Main Results:

• TEG and ROTEM generate sophisticated data on clot formation and dissolution kinetics.
• Independent contributions of platelets and fibrinogen to clot strength can be quantified.
• These technologies are increasingly used in algorithms for high-risk populations.

Conclusions:

• ROTEM and TEG offer detailed insights into blood coagulation dynamics.
• Their incorporation into clinical algorithms shows potential for reducing transfusions.
• Further research is needed to confirm improved patient outcomes with these diagnostic tools.