Examples of thromboelastometry
No clot formation due to very low factor levels or a heparin effect.
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.
Prolonged R value suggesting factor deficiency or possibly a minimal heparin effect.
Normal coagulation profile with adequate reversal of heparin by protamine. This is confirmed by the second trace with heparinase added.
Small alpha angle and small maximal amplitude with weak clot formation. This may be due to thrombocytopenia or hypofibrinogenaemia.
Short R value, borderline maximal amplitude. There is significant clot lysis due to poor platelet function and fibrinolysis.
Elongated R value, k value not readable, small alpha angle and small maximal amplitude. Due to technical error in thrombelastograph processing or severe coagulopathy.
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.