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Surgical Innovation
October 9, 2019

Thromboelastography-Guided Resuscitation of the Trauma Patient

Author Affiliations
  • 1Division of Trauma, Surgical Critical Care and Emergency Surgery, University of Pennsylvania Hospital Systems, Philadelphia
  • 2Department of Surgery, Corporal Michael J. Crescenz VA Medical Center, Philadelphia, Pennsylvania
  • 3Department of Surgery, Uniformed Services University of the Health Sciences, Bethesda, Maryland
JAMA Surg. Published online October 9, 2019. doi:10.1001/jamasurg.2019.3136

Thromboelastography (TEG) assesses coagulation throughout all phases of clot formation and is the most commonly used viscoelastic assay in the United States. Thromboelastography was originally developed in 1948 to evaluate inherited bleeding disorders. Thromboelastography has been used in the management of coagulopathy in multiple surgical settings, including the intraoperative phase of liver transplant and the postoperative management of patients after cardiac surgery.1 Thromboelastography analysis is now being more broadly applied to both characterize trauma-induced coagulopathy and to guide resuscitation during massive transfusions. This review explores the principles by which TEG assesses coagulation and examines the use of TEG results for clinical decision-making.

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