Thromboelastography, My Dear Doctor

  • Mark T. Friedman
  • Kamille A. West
  • Peyman Bizargity
  • Kyle Annen
  • Jeffrey S. Jhang


A 63-year-old man with a history of myocardial infarction and unstable angina is scheduled for coronary artery bypass graft (CABG) surgery with cardiopulmonary bypass (CPB). A preoperative ethylenediaminetetraacetic acid (EDTA) anticoagulant sample is submitted to the blood bank for type and screen along with a request for crossmatch of four units of red blood cells (RBCs) in preparation for the surgery.


Activated clotting time Antifibrinolytic agent Aminocaproic acid Fibrinogen concentrate Fibrinolysis RiaSTAP ROTEM TEG Thromboelastography Tranexamic acid Viscoelastic properties 


  1. 1.
    TEG® 5000 Thrombelastograph® Hemostasis Analyzer System. Haemonetics Corporation, Braintree, MA. Available at: Accessed 1 Nov 2017.
  2. 2.
    ROTEM®. Tem International, GmbH, Basel, Switzerland. Available at: Accessed 1 Nov 2017.
  3. 3.
    CYKLOKAPRON® Prescribing Information. Pfizer, New York, NY. October 2017.Google Scholar
  4. 4.
    Aminocaproic acid prescribing information. Hospira, Inc., Lake Forest, IL. September 2017.Google Scholar
  5. 5.
    RiaSTAP® Prescribing Information. CSL Behring LLC, Kankakee, IL. May 2016.Google Scholar
  6. 6.
    Karri JV, Cardenas JC, Johansson PI, Matijevic N, Cotton BA, Wade CE, Holcomb JB. In vitro efficacy of RiaSTAP after rapid reconstitution. J Surg Res. 2014;190(2):655–61.CrossRefGoogle Scholar

Recommended Reading

  1. Bose E, Hravnak M. Thromboelastography: a practice summary for nurse practitioners treating hemorrhage. J Nurse Pract. 2015;11(7):702–9.CrossRefGoogle Scholar

Copyright information

© Springer International Publishing AG, part of Springer Nature 2018

Authors and Affiliations

  • Mark T. Friedman
    • 1
  • Kamille A. West
    • 2
  • Peyman Bizargity
    • 3
  • Kyle Annen
    • 4
  • Jeffrey S. Jhang
    • 1
  1. 1.Icahn School of MedicineMount Sinai Health SystemNew YorkUSA
  2. 2.Department of Transfusion MedicineNational Institutes of Health Clinical CenterBethesdaUSA
  3. 3.Department of Molecular & Human GeneticsBaylor College of MedicineHoustonUSA
  4. 4.Department of PathologyChildren’s Hospital ColoradoAuroraUSA

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