Tromboelastography: variability and relation to conventional coagulation test in non-bleeding intensive care unit...

Area of Science:

• Critical Care Medicine
• Hematology
• Laboratory Medicine

Background:

• Intensive care unit (ICU) patients frequently exhibit abnormal laboratory results due to organ dysfunction.
• Thromboelastography (TEG®) provides a point-of-care assessment of coagulation.
• Understanding normal TEG® values in non-bleeding ICU patients is essential for accurate clinical interpretation.

Purpose of the Study:

• To determine the normal variability of Thromboelastography (TEG®) parameters in non-bleeding, non-transfused ICU patients.
• To establish reference ranges for TEG® in a specific ICU population.

Main Methods:

• Included adult ICU patients without recent bleeding or blood product transfusion.
• Collected standard clinical chemistry, coagulation tests, and TEG®.
• Compared TEG® values with routine coagulation tests using Spearman correlations.

Main Results:

• A high percentage (73%) of non-bleeding, non-transfused ICU patients had elevated TEG® maximum amplitude (MA) values.
• No patients displayed MA results indicative of hypocoagulability.
• Other observed coagulation changes included elevated D-Dimer, fibrinogen, APTT, and low ATIII.

Conclusions:

• Elevated TEG® MA values are common in unselected ICU patients without bleeding, suggesting a state of hypercoagulability.
• This finding is critical for the correct interpretation of TEG® in the ICU setting.
• TEG® interpretation in ICU patients requires consideration of this observed hypercoagulable tendency.