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Module 2
TEG Technology
Hemostasis monitoring
Routine coagulation tests: PT, aPTT
Based on cascade model of coagulation
Measure coagulation factors interaction in solution
(plasma)
Determine if adequate levels of coagulation factors
are present for clot formation
Do not reflect the roles of cells or contributions of
local vascular and tissue conditions
Plasma-based assays miss the impact of platelets and
platelet activation on thrombin generation.
Plasma-based assays use static endpoints (e.g. fibrin
formation) - miss impact of altered thrombin
generation on platelet function and clot structure.
Hemostasis monitoring
TEG analysis system
Identification
Definition
Thrombin formation
The R parameter - identified
Amplitude of
pin rotation
Initial fibrin
formation
Time
Intrinsic,
extrinsic,
common
pathways
Pin is Pin is
Pin starts to rotate with cup
stationary engaged
increases
Time
Pin is
engaged
Time
MA
Time
30 min
Fibrinolysis
The LY30 parameter - defined
Decrease in amplitude of pin rotation
30 minutes after MA reached
MA
30 min
G Derived from MA, represents the ultimate strength of the fibrin clot
LY30 LY30 measures the rate of amplitude reduction 30 minutes after MA.
This measurement gives an indication of the stability of the clot.
Amplitude of
pin rotation
Clot strength
Platelet function
30 min
Hemorrhagic TEG tracing
30 min
Prothrombotic TEG tracing
30 min
Fibrinolytic TEG tracing
30 min
Components of the TEG tracing
Example: R
Actual
value
Normal range
Parameter
Units
Value
Normal range
TEG decision tree
Qualitative
TEG decision tree
Quantitative
US Patent 6,787,363
Hemorrhagic
Fibrinolytic
Thrombotic
TEG tracing
Example: hemorrhagic
* *
*
*
TEG tracing
Example: prothrombotic
*
*
*
*
TEG tracing
Example: fibrinolytic
*
*
Summary
TEG parameters
Hemostasis monitoring
Begin
exercises Skip exercises
Exercise 1: TEG parameters
Answer Next
Exercise 2: TEG parameters
Answer Next
Exercise 3: TEG parameters
Answer Next
Exercise 4: TEG parameters
Answer Next
Exercise 5: TEG parameters
Answer Next
Exercise 6: TEG parameters
Answer Next
Exercise 7: TEG parameters
Answer Next
Exercise 8: TEG parameters
a. R
b. Angle (a)
c. MA
d. LY30
e. CI
Answer Next
Exercise 9: TEG parameters
Answer Next
Exercise 10: TEG parameters
a. R
b. Angle (a)
c. MA
d. LY30
e. CI
Answer Next
Exercise 11: Hemostasis monitoring
Answer Next
Exercise 12: Hemostasis monitoring
Answer Next
Exercise1: TEG parameters
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Exercise 2: TEG parameters
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Exercise 3: TEG parameters
Next
Exercise 4: TEG parameters
Next
Exercise 5: TEG parameters
Next
Exercise 6: TEG parameters
Next
Exercise 7: TEG parameters
a. R
b. Angle (a)
c. MA
d. LY30
e. CI
Next
Exercise 9: TEG parameters
Next
Exercise 10: TEG parameters
a. R
b. Angle (a)
c. MA
d. LY30
e. CI (Coagulation index: a linear combination of the R,
K, angle, and MA)
Next
Exercise 11: Hemostasis monitoring
Next
Exercise 12: Hemostasis monitoring
Next
End of Module 2