Review of Thromboelastography in Neurocritical Care

Introduction Thromboelastography (TEG), first described in Germany in 1948 by Dr. Hellmutt Hartert, is a test of the viscoelastic properties of whole blood, providing real-time analysis of hemostasis with information on the kinetics of clot formation and stability, from the initial thrombin burst to fibrinolysis. Maximal strength MA (maximal amplitude) in mm Measures abnormalities in fibrinogen concentration, platelet count, platelet function, factors VIII and XIII Amplitude (at set time in min) A30, A60 (amplitude at 30 and 60 min) Thrombolysis Maximal lysis (ML) Ly 30 (Lysis at 30 min) measured in % of MA LOT (Lysis onset time) CL30, CL60 (clot lysis at 30 and 60 min) Measures fibrinolytic enzymes, fibrinolysis inhibitors, Factor XIII Total clot strength G (calculated from amplitude) Maximum rate of thrombus generation D (delta time): Difference between R and SP Corresponds to time to maximum rate of thrombus generation Split point SP: the time from sample placement or activation until the earliest detectable resistance Table 2. In order to obtain this information otherwise, inferences from multiple tests would be required, including platelet count, platelet function, coagulation factors, fibrinogen, protein S, protein C, and antithrombin [11]. [...]there can be discrepancies between TEG and traditional coagulation tests.