The Role of Thromboelastography Testing in the Emergency Medicine, Trauma Center, and Critical Care Environments

Abstract

Thromboelastography (TEG) has been gaining attention for its potential use in a variety of disease of states to guide therapies and determine prognosis. This review will explore recent research specifically regarding the use of thromboelastography in the emergency, trauma, and critical care clinical environments. Thromboelastography has its drawbacks. TEG has wide operator and machine variability. Known coagulopathic states may exhibit normal viscoelastic results, indicating inconsistent results. Thromboelastography has shown to decrease transfusion of blood products in traumatic hemorrhage. In sepsis, both hypercoagulable and hypocoagulable states occur. Patients with certain neurological conditions may have disparate results on viscoelastic testing. Patients with intracranial bleeding and hematoma expansion were found to be hypocoagulopathic, whereas acute ischemic stroke patients tend to have hypercoagulopathic results. The bottom line is that thromboelastography requires further study before standard utilization for emergency and critical care departments.