Thrombelastography. Present and future perspectives in clinical practice.
Thrombelastography (TEG) is a method for evaluating the viscoelastic properties of the blood clot, from its formation to its lysis. All major surgeries may be associated with massive blood loss, with blood component transfusion therapy often becoming mandatory. The clinician's goal is thus to optimize and possibly minimize blood components usage. To this end, TEG allows for a qualitative and dynamic analysis of the specific blood clotting process, from clot formation through its lysis, highlighting alterations at every single step in the cascade. With TEG is thus possible to know if bleeding is due to a failure to provide adequate surgical hemostasis, if there is platelet dysfunction, or to detect anomalies in coagulation proteases or their inhibitors, or if the blood loss is associated to early, excessive fibrinolysis. The theoretical advantages of TEG are the ease of performing the test, the fast sample reading times (now 30 minutes) and the informative
Di Benedetto
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Department of Anesthesiology and Critical Care S. Andrea University Hospital, Rome, Italy. piadibe@hotmail.com
Baciarello
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Cabetti
L
L
Martucci
M
M
Chiaschi
A
A
Bertini
L
L
D001777:Blood Coagulation / Q000502:physiology; D001780:Blood Coagulation Tests; D016063:Blood Loss, Surgical / Q000517:prevention & control; D005260:Female; D005544:Forecasting; D006801:Humans; D016031:Liver Transplantation; D008297:Male; D016343:Monitoring, Intraoperative; D007744:Obstetric Labor Complications / Q000097:blood / Q000517:prevention & control; D006473:Postpartum Hemorrhage / Q000097:blood / Q000517:prevention & control; D011247:Pregnancy; D013916:Thrombelastography; D013927:Thrombosis / Q000097:blood*; D014592:Uterine Hemorrhage / Q000097:blood / Q000517:prevention & control; D014947:Wounds and Injuries / Q000097:blood / Q000601:surgery