Thromboelastography

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Author: Mikael Häggström, M.D. [note 1]

Interpretation

Normal thromboelastogram with parameters.

Parameters derived from thromboelastography are mainly:[1]

  • R time: Time to initial clot formation (that is, amplitude deviation from baseline)
  • K time: Time from initial clot formation until reaching 20 mm in amplitude
  • Alpha angle (α): Angle between the baseline at initial clot formation, and a tangent line that intersects the tracing curve.
  • Maximum amplitude (MA): Maximum deviation of tracing to baseline.
  • A30: Amplitude 30 minutes after reaching maximum amplitude.

Following are examples of thromboelastography patterns and recommended treatments.[2][3]

Condition Appearance Main treatment
Normal Normal thromboelastography.png
Hemodilution or clotting factor deficiency Thromboelastography in hemodilution or clotting factor deficiency.png Fresh frozen plasma
Fibrinogen deficiency Thromboelastography in fibrinogen deficiency.png Cryoprecipitate
Low or dysfunctional platelets Thromboelastography in low or dysfunctional platelets.png Platelets
Thrombosis Thromboelastography in thrombosis.png Anticoagulant
Primary fibrinolysis Thromboelastography in primary fibrinolysis.png Antifibrinolytics or tranexamic acid
Secondary fibrinolysis Thromboelastography in secondary fibrinolysis.png Treating disseminated intravascular coagulation

Notes

  1. For a full list of contributors, see article history. Creators of images are attributed at the image description pages, seen by clicking on the images. See Patholines:Authorship for details.

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References

  1. Tyler PD, Yang LM, Snider SB, Lerner AB, Aird WC, Shapiro NI (2021). "New Uses for Thromboelastography and Other Forms of Viscoelastic Monitoring in the Emergency Department: A Narrative Review. ". Ann Emerg Med 77 (3): 357–366. doi:10.1016/j.annemergmed.2020.07.026. PMID 32988649. 
  2. Collins S, MacIntyre C, Hewer I (2016). "Thromboelastography: Clinical Application, Interpretation, and Transfusion Management. ". AANA J 84 (2): 129–34. PMID 27311154. Archived from the original. . 
  3. Kreitzer NP, Bonomo J, Kanter D, Zammit C (2015). "Review of Thromboelastography in Neurocritical Care. ". Neurocrit Care 23 (3): 427–33. doi:10.1007/s12028-015-0187-9. PMID 26275677. Archived from the original. . 

Image sources