Thromboelastometry Versus Rotational Thromboelastography in Cardiac Surgery

Semin Cardiothorac Vasc Anesth. 2017 Sep;21(3):206-211. doi: 10.1177/1089253217697146. Epub 2017 Mar 1.

Abstract

Evidence exists on the morbiduty and mortality associated with both massive blood loss and transfusion in cardiac surgical patients. Monitoring of the vesicoelastic properties of blood using rotational thromboelastometry and thromboelsatography (TEG) has been a major step towards ameliorating the risks associated with these 2 evils by providing trageted goal-directed blood product resuscitation. Point of care ROTEM and TEG overcome many of the current limitatons of conventional laboratory coagulation testing. Despite the peaking interest and widespread use there is a lack of consensus whetehr the use of these devices to guide blood product resucistation is associated with a reduction in mortality. Also, both ROTEM and TEG suffer from some limitations resulting in a lack of agreement on the duperiority of one device versus the other. In this concise review we discuss the operational charecteristics of both devices and the pro-side of the use of ROTEM in cardiac surgery backed with the most recent evidence.

Keywords: antifibrinolytics; blood loss; cardiac anesthesia; cardiopulmonary bypass; coagulopathy.

Publication types

  • Comparative Study
  • Review

MeSH terms

  • Blood Loss, Surgical / prevention & control*
  • Blood Transfusion / methods
  • Cardiac Surgical Procedures / methods*
  • Humans
  • Point-of-Care Systems
  • Resuscitation / methods
  • Thrombelastography / methods*