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thromboelastography (TEG)
Indications:
- may have a role in guiding fresh frozen plasma use in trauma
- may have role as point of care test to assess eligibility in patients taking direct oral anticoagulants (DOAC) for thrombolysis for ischemic stroke (not yet a validated measure) [2]
Principle:
- measures viscoelastic properties of blood clot [1]
Clinical significance:
- provides assessment of clotting ability
- correlates with serum DOAC levels [2]
Specimen:
- whole blood
General
elastography
clinical hematology test
point of care test
References
- N Engl J Med Journal Watch. Jan 24, 2014.
Massachusetts Medical Society
http://www.jwatch.org
- McCully SP, Fabricant LJ, Kunio NR et al
The International Normalized Ratio overestimates coagulopathy
in stable trauma and surgical patients.
J Trauma Acute Care Surg. 2013 Dec;75(6):947-53.
PMID: 24256665
- Lou N
Holding tPA for All DOAC Users Not the Way to Go, Stroke Docs Say.
Clinical conundrum could be solved by a point-of-care DOAC test.
MedPage Today March 15, 2021
https://www.medpagetoday.com/neurology/strokes/91633
- Seiffge DJ, Wildon D, Wu TYH et al
Administering thrombolysis for acute ischemic stroke in patients taking
direct oral anticoagulants: to treat or how to treat.
JAMA Neurol 2021. March 15
PMID: 33720313
https://jamanetwork.com/journals/jamaneurology/article-abstract/2777622
- Czap AL, Grotta JC
Complexities of reperfusion therapy in patients with ischemic stroke
pretreated with direct oral anticoagulants: to treat or not, and how?
JAMA Neurol 2021
PMID: 33720276
https://jamanetwork.com/journals/jamaneurology/article-abstract/2777623