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Plenary paper
Is thromboelastography (TEG)-based resuscitation better than empirical 1:1 transfusion?
  1. Isaac W Howley1,
  2. Elliott R Haut2,
  3. Lenwoth Jacobs3,
  4. Jonathan J Morrison1,
  5. Thomas M Scalea1
  1. 1 R Adams Cowley Shock Trauma Center, University of Maryland, Baltimore, Maryland, USA
  2. 2 Department of Surgery, The Johns Hopkins University, Baltimore, Maryland, USA
  3. 3 Department of Traumatology and Emergency Medicine, University of Connecticut School of Medicine, Farmington, Connecticut, USA
  1. Correspondence to Dr Jonathan J Morrison, R Adams Cowley Shock Trauma Center, University of Maryland, Baltimore, MD 21201, USA; jonathan.morrison{at}umm.edu

Abstract

Thomboelastography (TEG) is a whole blood measure of coagulation which was originally described in the 1950s. However, it has only been in the last few decades that assays have become accessible and viable as a point-of-care test. Following the observation that hemorrhagic shock is associated with an intrinsic coagulopathy, TEG has been used as a method of diagnosing specific coagulation defects in order to direct individualized blood products resuscitation. An alternative transfusion strategy is the administration of fixed ratio products, a paradigm borne out of military experience. It is unknown which strategy is superior and this topic was debated at the 36th Annual Point/Counterpoint Acute Care Surgery Conference. The following article summarizes the discussants points of view along with a summary of the evidence.

Level of evidence Level III.

  • coagulopathy of trauma
  • coagulation tests
  • blood transfusion
  • shock resuscitation

This is an Open Access article distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/

https://doi.org/10.1136/tsaco-2017-000140

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    Footnotes

    • This study was presented at the 36th Point/Counterpoint Acute Care Surgery Conference Proceedings on 11–12 May 2017, Baltimore, Maryland, USA.

    • Contributors IWH, ERH, LJ: debater, manuscript editing. JJM: manuscript writing. TMS: conception, manuscript editing.

    • Competing interests None declared.

    • Provenance and peer review Not commissioned; externally peer reviewed.