Key result
TEG detects unexpected coagulopathy missed by standard tests, enabling targeted perioperative management.
Why the study?
Standard perioperative coagulation tests may not detect coagulopathy during acute normovolemic hemodilution after induction of general anesthesia.
Does thrombelastography (TEG) detect unexpected coagulopathy better than standard coagulation tests during acute normovolemic hemodilution?
Case Report (n=1)
No
Does thrombelastography (TEG) detect unexpected coagulopathy better than standard coagulation tests during acute normovolemic hemodilution?
Thrombelastography can detect unexpected perioperative coagulopathy that standard coagulation tests may miss, allowing for timely and effective management.
TEG may enable targeted management when standard tests miss coagulopathy; leaves open superiority in acute normovolemic hemodilution.
Thrombelastography (TEG) performed by an anesthesiologist provides a rapid assessment of coagulation at the bedside.TEG analyzing coagulation status of native whole blood is a more accurate test with a relatively good sensitivity and specificity than PT and aPTT.We experienced an unexpected coagulopathy during the perioperative period.The case was a 47-year-old male patient with blood type O who underwent elective spine surgery.Perioperative coagulation tests (PT, aPTT, BT, CT, etc.) were within normal limits.Anesthesia was induced with propofol 90 mg, vecuronium 8 mg and alfentanil 0.5 mg and maintained with 1.0-1.5 vol% enflurane and 50% N2O in O2.Then we performed acute normovolemic hemodilution (ANH) with monitoring pre-and post-hemodilutional TEG.Hemostasis was revealed as abnormal by a pre-hemodilution TEG (CI = -11.06)and post-hemodilution TEG (CI = -13.06).We managed this coagulopathy with blood components and drugs on the basis of a follow-up TEG so that abnormal hemostasis and TEG findings improved (CI = -4.35).We report a case where undetected coagulopathy was revealed and treated successfuly with TEG.(Korean J Anesthesiol 2003; 44: 265∼ 270) ꠏꠏꠏꠏꠏꠏꠏꠏꠏꠏꠏꠏꠏꠏꠏꠏꠏꠏꠏꠏꠏꠏꠏꠏꠏꠏꠏꠏꠏꠏꠏꠏꠏꠏꠏꠏꠏꠏꠏꠏꠏꠏꠏꠏꠏꠏꠏꠏꠏꠏꠏꠏꠏꠏꠏꠏꠏꠏꠏꠏꠏꠏꠏꠏꠏꠏꠏꠏꠏꠏꠏꠏꠏꠏꠏꠏꠏꠏꠏꠏꠏꠏꠏꠏꠏꠏ
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Jeong et al. (2003) conducted a case report in Perioperative coagulopathy (n=1). Thrombelastography (TEG) was evaluated on Coagulation status assessment. Thrombelastography successfully detected an unexpected coagulopathy that was missed by standard preoperative tests, allowing for successful targeted management with blood components and drugs.
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