Table 1 Recommended TEG algorithm for goal-directed therapy of bleeding patients in the Capital Region of Denmark

R >10 min

Coagulation factors ↓

FFP 10–20 ml/kg (if FFP is without clinical efficacy, consider cryoprecipitate 3–5 ml/kg)

Angle <52 °

Hypofibrinogenemia?

→ Functional Fibrinogen (FF) analysis

MA <49 mm and

MA _FF <14 mm

Fibrinogen ↓

FFP 20–30 ml/kg /

Fibrinogen konc. 25–50 mg/kg /

Cryoprecipitate 5 ml/kg

MA <49 mm and

MA _FF >14 mm

Platelets ↓

Platelets 5–10 ml/kg

Ly30 >8%

Primary hyperfibrinolysis

Tranexamic acid 1–2 g IV (adults)

Children 10–20 mg/kg IV

Ly30 >8% and

Angle and/or MA ↑↑

Reactive hyperfibrinolysis

Tranexamic acid contraindicated

Difference in R >2 min between st-TEG and hep-TEG

Heparinization

Protamine sulphate or FFP 20–30 ml/kg