TEGŪ Point-of-Care Test 

The TEGŪ analyzer provides a global, point-of-care test of hemostasis that can identify whether the patient has a normal hemostasis or if he is bleeding, whether it is due to surgical, coagulopathy, or residual anticoagulation therapy. If the patient has a coagulopathy, the TEGŪ results will identify the specific therapy to treat it, whether he needs FFP, cryo, platelets, antifibrinolytic drugs, or thrombolytic drugs. In fact, these therapies can first be applied in vitro to confirm their effect on the patient sample before the patient himself is treated. Kang et al found that "[t]he judicious use of a small dose of  epsilon-aminocaproic acid, when its efficacy was confirmed in vitro (by TEGŪ analysis), effectively treated the severe fibrinolysis without clinical thrombotic complications." 

Dr. Linda Shore-Lesserson, in her prospective study of cardiac surgery, concluded that "[o]ur results indicate that the use of TEGŪ analysis in a transfusion algorithm allowed for identification and appropriate treatment of specific intraoperative abnormalities of hemostasis. This intervention resulted in fewer postoperative transfusions and improved hemostasis. TEGŪ results are readily available in the operating room thus making it effective as a point-of-care coagulation monitor." 

The TEGŪ analyzer is a monitoring device, not unlike the EKG, in that it is run to confirm that patient hemostasis is normal, and according to  Kang et al if hemostasis is not normal, the "TEG[Ū analyzer] assists in making differential diagnosis of coagulopathy and guides selective replacement of pharmacological therapy." 

We are not advocating that the TEGŪ analyses replace standard laboratory tests. There is no conflict between them; on the contrary, they are complementary. The TEGŪ system tests have limitations that are well known. 

The TEGŪ system was not designed to identify the specific factor, inhibitor, or activator responsible for the coagulopathy. If the TEGŪ tracing shows coagulopathy, it will provide differential treatment in the form of FFP, platelets, cryo, or anti-fibrinolytic, anti-thrombolytic or anti-coagulant drugs, but if it is necessary to identify the specific factor, coagulation laboratory tests then become important and necessary.  The TEGŪ system was designed to be specific in determining whether the developing clot can sustain hemostasis. If it can, then the use of laboratory tests will add unnecessary cost and/or provide misleading information, as was documented earlier. If the developing clot cannot sustain hemostasis and show coagulopathy, however, the TEGŪ system may show which of the other laboratory tests are unnecessary. 

Recently, due to dramatic changes in health care systems worldwide, the reduction of cost has become a prominent factor in the economic survival of the hospital. The TEGŪ test, as a point-of-care test, has proven itself an extremely useful tool in achieving this goal. In addition to the elimination of the number of laboratory tests, the TEGŪ analyzer was instrumental in reducing blood component transfusion and the rate of reoperation [Plevak, Kang, Shore-Lesserson, Spiess, Kang, Kang].