2012-08-22

Sep 14, 2018 How do thromboelastography (TEG)‐ and thromboelastometry (ROTEM)‐guided transfusions affect outcomes of people with bleeding?

Conventional TEG teaching ⇒ if there’s a low α angle, give fibrinogen or platelets; ROTEM FIBTEM system can differentiate between the two conditions to guide transfusion; 10-40-80 rule ⇒ you don’t have to remember PT & PTT or platelet thresholds at 2 in the morning! If FIBTEM A10 Thromboelastography (TEG) is a viscoelastic hemostatic assay that measures the global viscoelastic properties of whole blood clot formation under low shear stress TEG shows the interaction of platelets with the coagulation cascade (aggregation, clot strengthening, fibrin cross-linking and fibrinolysis) But in all my travels, I’ve see very few centers that have fully, effectively, and contemporaneously incorporated TEG or ROTEM into their massive transfusion protocol from start to finish. The area where TEG and ROTEM are most helpful are in the “mop up” phase at the tail end of the MTP. Bottom line – There is growing evidence to suggest that the utilization of TEG and ROTEM reduce transfusion requirements and improve morbidity in patients with bleeding, but additional studies are required. Back to Our Case Why was the trauma surgeon concerned?

TEG (Trombelastografi). Mäter global Adekvat fysiologi. • Vitalparametrar. • Laktat, BE. • TEG, ROTEM. • TEE. • CO-mätning.

INTRODUCTION: The understanding of coagulopathies in trauma has increased interest in thromboelastography (TEG®) and thromboelastometry (ROTEM®), which promptly evaluate the entire clotting process and may guide blood product therapy. Our objective was to review the evidence for their role in diagnosing early coagulopathies, guiding blood transfusion, and reducing mortality in injured …

Our trauma program is relatively new (Nov 2011) and as we bring in more trauma surgeons they are pushing for one of these. It has been mentioned that our CVOR program actually purchased TEG many years ago but never put it into use as it was difficult to interpret at that time.

Mar 25, 2021 TEG and ROTEM direct early transfusion of fresh frozen plasma when clinical gestalt has not activated a massive transfusion protocol. Reaction

• Fibrinogen om: • FIBTEM A5 Global viscoelastic test of whole blood (TEG / ROTEM) produce a dynamic side, point of care protocol based on thromboelastometry to guide transfusion and the relationships with warfarin and TEG values related to transfusion amount, to set ROTEM values at 30min after anaesthetic induction and 30min after ICU GI-‐blödning. Transfusion vid Hb < 70 g/L vs Hb < 90 g/L TACO (Transfusion Related Circulatory Overload). Syfilis Normalisering av PK, APT-‐T och TEG Thrombelastogram (Rotem); Normal thrombelastogram; TEG (Rotem) with thrombocytopenia; TEG with fibrinogen deficiency; TEG with increased fibrinolysis Semantic Scholar extracted view of "TEG och ROTEM--patientnära och snabba Variability in transfusion practice and effectiveness of strategies to improve it.

In order to perform a TEG, a citrated-sample of whole blood is placed into a heated sample cup with calcium chloride (to overcome the effects of the citrate), kaolin (a negatively charged molecule known to initiate the intrinsic pathway 10), and phospholipids (required for optimal functioning of the extrinsic pathway 11) (Figure 2). Effect of thromboelastography (TEG®) and rotational thromboelastometry (ROTEM®) on diagnosis of coagulopathy, transfusion guidance and mortality in trauma: descriptive systematic review.
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Sankarankutty, Ajith, et al. "TEG® and ROTEM® in trauma: similar test but different results." World J Emerg Surg 7.Suppl 1 (2012): S3.. Coakley, Margaret, et al. "Transfusion triggers in orthotopic liver transplantation: a comparison of the thromboelastometry analyzer, the thromboelastogram, and conventional 2016-05-01 2012-09-13 Transfusion of haemostatic blood products such as fresh frozen plasma, cryoprecipitate, platelets and clotting factor concentrates may be guided by clinical judgement, standard laboratory tests, thromboelastography (TEG) or rotational thromboelastometry (ROTEM), or a combination of these in transfusion algorithm. 2014-11-24 Transfusion Requirements.

Tromboelastometri och tromboelastografi (ROTEM/TEG) är patientnära koagulationsanalyser, som på bred front introduceras i syfte att styra behandling vid massiv blödning och koagulopati.
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Följ blodprover med 4 – 6 timmars intervall: Hb, TPK, PK, APTT, S-Ca, P-. Fibrinogen, Tromboelastografi (TEG/ROTEM). Kirurgisk intervention (

METHODS: The methods used for this study were systematic reviews with meta-analyses and trial sequential analyses of randomised clinical trials (RCTs) of TEG/ROTEM-based algorithm compared with standard treatment in patients with bleeding.

Use of ROTEM and TEG in transfusion algorithms either alone or in combination with other rapid POC tests such as whole blood platelet multiple electrode aggregometry (MEA) allows goal directed hemostatic therapy to take place with administration of nonerythrocyte blood products administered to address specific deficiencies.

studies have shown that both ROTEM- and TEG-guided treatment algorithms usage of blood products compared to empiric massive transfusion protocols. Blodtransfusion. Blödning < ½ blodvolym TEG, snabbare resultat.

Operational Aspects of the Transfusion Service/Blood Bank . If rapid TEG is available, the following cut-points for (ROTEM®) is available, the following cut Oct 21, 2020 haemostatic assay (VHA) augmented transfusion strategy compared Cochrane Review concluded that TEG or ROTEM guided transfusion Dec 1, 2020 RESULTS: Using TEG/ROTEM-guided blood transfusions in acutely bleeding trauma, surgical, and critically ill patients was associated with a Feb 19, 2015 Walsh +Skupski TEG:ROTEM:EPGAS Feb 2015 thromboelastometry (ROTEM ®) on diagnosis of coagulopathy, transfusion guidance and Nov 4, 2016 A 24 minute overview on ROTEM, TEG. Topics covered include a historical background to ROTEM, the evidence for it, how to interpret and run Oct 11, 2017 The authors routinely use rTEG to guide blood product transfusions and kTEG to guide antiplatelet therapy in the intensive care unit for post-injury Red blood cell (RBC) transfusion is independently associated with a For both populations the cost-effectiveness of ROTEM, TEG and Sonoclot were compared. FFP, plt transfusions (30 exploration (OR 0.34) (Bolliger 13).