Tromboelastography

PhD ceremony: Mr. W.W.H. Roeloffzen, 14.30 uur, Academiegebouw, Broerstraat 5, Groningen

Dissertation: Tromboelastography

Promotor(s): prof. J.C. Kluin-Nelemans

Faculty: Medical Sciences

Thromboelastography (TEG), an approximate test of haemostasis, has the advantage over classical coagulation tests that it is performed at the bedside and in whole blood, offering a rapid overview of the sum of the cumulative effects of plasma factors as well as interacting cellular elements. TEG was initially used to guide transfusion in the setting of hepatic, cardiovascular and trauma surgery, but nowadays its use has been expanded to all other areas of haemostasis and thrombosis testing.

The scope of this thesis is to improve the understanding of TEG technology for clinicians working in the field of haemostasis, making them aware of the possibilities and the limitations of TEG in coagulation monitoring. For this purpose, an overview is given on the role of TEG and other point-of-care tests of haemostasis in both the prediction and treatment of massive blood loss. Further, TEG was validated by obtaining and describing normal reference ranges. In contrast to classical coagulation tests, and in spite of its approximate character, TEG is able to detect the effects of age, gender and oral anticonceptives on the coagulation profile. Also, TEG seems capable of demonstrating the effects of platelets and red blood cells on haemostasis and has potential as an in vivo quality test of blood products. Finally, TEG might play a future role in patients with sickle cell disease since the technique is able to monitor the pro-coagulant status of these patients, as well as the effects of treatment with hydroxyurea on this status.