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Thromboelastography Associates to Decreased Plasma Transfusions in the Medical Intensive Care Unit: A Retrospective
Daniel F Lewandowski1,2, Connor M Bunch1,2,3, Morgan N Howard4
1Department of Pulmonary and Critical Care Medicine, Henry Ford Hospital, Detroit, Michigan, USA, henryford.com.
Critical Care Research and Practice
|April 23, 2026
Summary
Thromboelastography (TEG) guided resuscitation in the medical intensive care unit (MICU) conserved plasma use. This retrospective study found TEG did not significantly impact mortality or length of stay, suggesting further research into blood product stewardship.
Area of Science:
- Critical Care Medicine
- Hematology
- Transfusion Medicine
Background:
- Coagulopathy is common in critically ill patients, necessitating effective blood product resuscitation strategies.
- Viscoelastic tests like thromboelastography (TEG) are increasingly used to guide hemostasis restoration in intensive care settings.
Purpose of the Study:
- To evaluate the impact of implementing TEG-guided blood product resuscitation in a medical intensive care unit (MICU).
- To compare blood product usage, mortality, and hospital length of stay between historical and TEG-guided cohorts.
Main Methods:
- Retrospective study comparing a historical cohort (pre-TEG availability) with an observational cohort (TEG-guided) in a tertiary care MICU.
- Included adult patients (>18 years) admitted to the MICU who received blood component therapy.
- Analyzed plasma administration volumes, mortality rates, and hospital length of stay.
Main Results:
- The TEG-guided cohort received significantly less plasma compared to the historical cohort (410.8 mL/patient vs. 658.3 mL/patient, p < 0.001).
- No significant differences were observed in mortality (50.5% vs. 54.4%, p = 0.408) or hospital length of stay (14 days vs. 13 days, p = 0.08).
Conclusions:
- TEG-guided blood component resuscitation in a general MICU population was associated with reduced plasma utilization.
- While this study did not establish causality due to its retrospective nature, it supports further investigation into TEG's role in blood product stewardship.
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