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Overview of thromboelastometry interpretation

Created: 30/8/2005


Examples of thromboelastometry

Example 1 

No clot formation due to very low factor levels or a heparin effect.

Example 2 

A: No coagulation at all – due to whole blood from a heparinised patient
B: Normal curve – due to whole blood after the addition of heparinase.

Example 3
Prolonged R value suggesting factor deficiency or possibly a minimal heparin effect.

Example 4
Normal coagulation profile with adequate reversal of heparin by protamine. This is confirmed by the second trace with heparinase added.

Example 5
Small alpha angle and small maximal amplitude with weak clot formation. This may be due to thrombocytopenia or hypofibrinogenaemia.

Example 6
Short R value, borderline maximal amplitude. There is significant clot lysis  due to poor platelet function and fibrinolysis.

Example 7

Elongated R value, k value not readable, small alpha angle and small maximal amplitude. Due to technical error in thrombelastograph processing or severe coagulopathy.

Example 8
Short R value, short k value, large alpha angle and large maximal amplitude. No fibrinolysis evident, possibly due to aggressive replacement of factors, e.g. platelet rich plasma  or chronic hypercoagulable states.

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