Thromboelastography (TEG) as a tool to guide product replacement in the gravid patient with severe blood loss

The use of TEG (Thromboelastography) is utilized more and more in the intraoperative setting where either severe bleeding is a factor, or where iatrogenic alterations in coagulation are indicated, such as cardiac surgery.... [ view full abstract ]

The use of TEG (Thromboelastography) is utilized more and more in the intraoperative setting where either severe bleeding is a factor, or where iatrogenic alterations in coagulation are indicated, such as cardiac surgery. Given that a TEG provides information about coagulation status from whole blood rather than just from plasma, if used appropriately, it should allow a clinician to transfuse product more precisely. In specific patient populations that are inherently hypercoagulable such as gravid patients, TEG could potentially be used to perfectly titrate the administration of platelets, FFP, and fibrinogen to ensure the optimum level of coagulation. This would be especially useful in gravid patients with severe hemorrhage requiring massive transfusion.