Thromboelastography (TEG)

[bmarotto]

Our lab is getting pressured by a cardiac surgeon and anesthesia to bring in a TEG analyzer. They say it will result in a decrease use of blood components. The lab director is strongly opposed to TEG and has vetoed it for the past several years. As a result, the surgeon is now bringing it to Transfusion Committee for discussion. We have a new CEO who is pushing blood conservation so there may be support from Administration.

I would like to hear from anyone who has experience with TEG, whether positive or negative. Also, did it fall under the lab as a POC device and who interpreted the graphs...anesthesia or a pathologist?

Thanks in advance.

[epfeiffer]

At the hospital I used to work at we did have a TEG. The graphs were interpreted by the Anesthesiologist and the Perfusionist and actually our point of care had little to do with this intrument. In addition I feel the aforementioned interpreters had little to do with it as well, as they never refered to results from this analyzer when ordering blood products. The seemed to feel that surgery required no justification for transfusion and just ordered products whenever they felt like it, without any clinical indications that transfusions were actually neccessary.

[jayinsat]

We used it at one facility where I worked and we saw NO decrease in blood usage! In my opinion, it was a waste. It was useful in determining the best product but it seemed the physicians most likely to benefit never relyed on it.

[bluealpaka]

We use TEG at our hospital but so far they have shown no proof that it reduces blood usage. The TEG is interpreted on the spot by the anesthesiologist or surgeon, but mostly anesthesiology uses it. The different docs in anesth. do not routinely use it across the board, either. Only some of them use it. The hospital where I came from had TEG usage as well despite a big effort of the Lab Dir. who opposed it (he was a coagulation specialist). It is a passing fad and the prinicple of the TEG has been around for decades.