Cath Hurn: TEG/ROTEM in the real world

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Hurn talks us through thrombelastography on the front line.

Published in: Health & Medicine, Business

Cath Hurn: TEG/ROTEM in the real world

  1. 1. TEG in the real world Know your weapons Catherine Hurn SMACC 2013
  2. 2. 3-4 points take away… Some new vocabulary As for TEG what it does what it might do and what it doesn’t do
  3. 3. Vocabulary ATC ACoTS TICTEG ROTEM ETIC
  4. 4. Vocabulary ATC ACoTS TIC ETIC Acute traumatic coagulopathy Trauma induced coagulopthy Early trauma induced…. Acute coagulopathy of traumatic shock
  5. 5. Coagulopathy definition 1.5 times normal INR 1.5, aPTT 60 INR 1.2
  6. 6. Brohi 2010
  7. 7. Maybe we just need another test…
  8. 8. Potential roles for TEG 1. Early diagnosis of coagulopathy 2. Indicator of prognosis 3. Guiding blood transfusion
  9. 9. 1. Early diagnosis of coagulopathy ATC characterized by reduced clot strength
  10. 10. 2. Indicator of patient outcomes 3 x more likely to receive transfusion 70% required a MT
  11. 11. 3. Guiding blood transfusion
  12. 12. Fig 1 Algorithm for goal-directed massive transfusion. The transfusion algorithm relies on thrombelastography (TEG) tracing variables to direct blood component therapy. <ce:italic> r-TEG,</ce:italic> Rapid TEG; <ce:italic> ACT,</ce:italic> acti... Michael Pezold , Ernest E. Moore , Max Wohlauer , Angela Sauaia , Eduardo Gonzalez , Anirban Banerjee , Christophe... Viscoelastic clot strength predicts coagulation-related mortality within 15 minutes Surgery Volume 151, Issue 1 2012 48 - 54 http://dx.doi.org/10.1016/j.surg.2011.06.023
  13. 13. rTEG trace
  14. 14. Potential roles for TEG 1. Early diagnosis of coagulopathy 2. Revealing patient prognosis 3. Guiding blood transfusion 4. Assess Dabigatran 5. Assess risk for PE
  15. 15. In the real world…
  16. 16. ISSUES Tricky Small cohort Dud test results Really POC?

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