Methodology

Method: TEG6s harmonic resonance elasticity. 

Analytical Volume: 400 µL whole blood

Limitations: Results may be influenced by anticoagulants (e.g. bivalirudin, heparin), hematocrit, and platelet count. Viscoelastic testing (TEG) is not a specific or validated assay for monitoring therapeutic anticoagulation. Drug-specific assays (e.g., bivalirudin level or unfractionated heparin activity) should be used for anticoagulation monitoring, when applicable. Improper specimen collection (e.g., underfilled tubes, hemolysis) may lead to inaccurate results.

TEG Manager is an accessory application that provides remote viewing of TEG analyzer test results and administration of all connected analyzers. Anesthesia can launch TEG Manager (access in Citrix Workspace with your SCH network username and password); other teams can view results in Epic upon test completion. 

CK: Kaolin is a standardized reagent consisting of dry Kaolin  and 0.85% Saline solution. Kaolin -activated tests methods are used to reduce variability and to reduce the running time of a native whole blood sample. Use of these particles of hydrated aluminum silicate shortens the coagulation time because Kaolin acts as a contact surface activator (intrinsic pathway), which activates Factor XII and platelets and stimulates the reserve clotting ability of a blood sample. Kaolin is combined with CaCl₂ to neutralize any sodium citrate in the blood

CKH: Heparin is commonly used as an anticoagulant in surgical procedures. Even in very low concentrations of heparin, fractions of IU/mL of blood, can noticeably increase the R time and can even completely anticoagulate the blood, making it difficult if not impossible to monitor developing coagulopathies that are masked by high levels of therapeutic heparin. The addition of heparinase in the assay cartridge neutralizes the effect of heparin in the sample. CaCl₂ is included to neutralize any sodium citrate in the blood. 

CRTH: RapidTEG maximally accelerates the clotting process by simultaneously activating the intrinsic and extrinsic coagulation pathways using a high concentration of Kaolin and Tissue Factor (TF). This closely reflects the physiological clotting process and yields results significantly faster than the native, Kaolin, and/or TF activated test. The addition of heparinase in the assay cartridge neutralizes the effects of heparin in the sample. CaCl₂ is included to neutralize any sodium citrate in the blood. 

 CFFH: The Functional Fibrinogen reagent activates the extrinsic pathway using tissue factor and inhibits platelet aggregation using a platelet inhibitor that binds to GPIIb/IIIa receptors. By excluding the platelet aggregation contribution to clot strength (MA), the reagent measures fibrinogen contribution. The addition of heparinase in the assay cartridge neutralizes the effects of heparin in the sample. Functional Fibrinogen is combined with CaCl₂ to neutralize any sodium citrate in the blood.