Management of Trauma-Induced Coagulopathy with Thrombelastography

Crit Care Clin. 2017 Jan;33(1):119-134. doi: 10.1016/j.ccc.2016.09.002.

Abstract

Viscoelastic assays, such as thrombelastography (TEG) and rotational thrombelastometry (ROTEM), have emerged as point-of-care tools that can guide the hemostatic resuscitation of bleeding injured patients. This article describes the role of TEG in contemporary trauma care by explaining this assay's methodology, clinical applications, and result interpretation through description of supporting studies to provide the reader with an evidence-based user's guide. Although TEG and ROTEM are assays based on the same viscoelastic principle, this article is focused on data supporting the use of TEG in trauma, because it is available in trauma centers in North America; ROTEM is mostly available in Europe.

Keywords: Coagulopathy; Fibrinolysis; Resuscitation; TEG; Thrombelastography; Transfusion.

Publication types

  • Review

MeSH terms

  • Blood Coagulation Disorders / etiology*
  • Blood Coagulation Disorders / therapy*
  • Europe
  • Humans
  • North America
  • Practice Guidelines as Topic*
  • Thrombelastography / standards*
  • Wounds and Injuries / complications*
  • Wounds and Injuries / diagnosis
  • Wounds and Injuries / therapy*