Skip to main content

Table 2 Studies evaluating the effect of TEG vs. routine coagulation tests (RCoT) on haemostasis in surgical patients

From: Thrombelastography and tromboelastometry in assessing coagulopathy in trauma

Author Patients No. Study type Major conclusions
Kang (1985) Liver surgery 66 RC VHA based therapy reduced blood and fluid infusion volume by 33% vs. RCoT therapy
McNicol (1994) Liver surgery 75 RC VHA enabled specific and selective use of FFP, PLT and cryoprecipitate
Kang (1995) Liver surgery 80 RC VHA identified clinically relevant fibrinolysis and enabled specific pharmacological therapy
Harding (1997) Liver surgery 55 RC VHA-heparinase enabled identification of coagulopathy present under the heparinisation
Chau (1998) Liver surgery 20 PO VHA predicted re-bleeding in cirrhotic patients with variceal bleeding, whereas RCoT did not
Tuman (1987) Cardiac surgery 87 RC VHA allowed rapid intraoperative diagnosis of coagulopathy during CPB
Spiess (1987) Cardiac surgery 38 RC VHA was a better predictor (87% accuracy) of postoperative haemorrhage and need for reoperation than RCoT (30-51% acuracy)
Tuman (1989) Cardiac surgery 42 RC VHA, but not RCoT, predicted postoperative bleeding in patients post-CPB
Essell (1993) Cardiac surgery 36 PO VHA had higher specificity in predicting patients likely to benefit from FFP and PLT therapy than RCoT
Tuman (1994) Cardiac surgery 51 RC VHA-heparinase revealed post-CPB coagulopathy
Spiess (1995) Cardiac surgery 1,079 PI vs. RC VHA guided transfusion therapy significantly reduced overall incidence of transfusion and total transfusions in the OR as compared to RCoT
Shih (1997) Cardiac surgery 43 RC VHA demonstrated higher sensitivity and specificity than RCoT for detecting post-CPB bleeding
Cherng (1998) Cardiac surgery 74 RC Re-do patients demonstrated reduced pre-operative α-angle and MA/MCF was significantly reduced compared to patients not needing re-exploration
Shore-Lesserson (1999) Cardiac surgery 105 RCS VHA treated patients received fewer postoperative FFP and PLT transfusions than patients treated based on PCoT
Royston (2001) Cardiac surgery 90 IS VHA guided transfusion therapy reduced the need for FFP and PLT threefold vs. RCoT
Manikappa (2001) Cardiac surgery 150 RCS VHA had higher accuracy than RCoT to predict patients developing excessive postoperative bleeding and significantly reduced the need for RBC, FFP and PLT transfusions
Welsby (2006) Cardiac surgery 30 PO VHA MA/MCF showed better correlation with postoperative bleeding than RCoT
Anderson (2006)* Cardiac surgery 990 PI vs. RC VHA guided therapy reduced the need for RBC, FFP and PLT as compared to RCoT directed therapy
Westbrook (2008) Cardiac surgery 69 RC VHA-based management reduced total product usage by 58.8% in the study group vs. RCoT group
Reinhöfer (2008)* Cardiac surgery 150 RC Clot strength, but not RCoT, had the highest predictive value for excess postoperative blood loss
Johansson (2009) Massive transfusion 832 PI vs. RC VHA guided therapy reduced mortality from 31% to 20% in massively bleeding patients
  1. *ROTEM, RCoT = routine coagulation tests, PO = Prospective observational study, RC = Retrospective cohort study, RCS = Randomised clinical study, PI vs. RC = Prospective interventional study vs. retrospective controls, IS = Interventional study