Maximizing Blood Conservation in Cardiac Surgery with Thromboelastography (TEG): The Vital Role of the Perfusionist

Maximizing Blood Conservation in Cardiac Surgery with Thromboelastography (TEG): The Vital Role of the Perfusionist

Thromboelastography (TEG) is a cutting-edge diagnostic tool used in cardiac surgery to monitor the coagulation process and assist with blood conservation. This innovative test provides real-time information about the patient's blood coagulation status, enabling the surgeon to make more informed decisions about the use of blood products and other coagulation-altering therapies. In this blog post, we will discuss the role of TEG in cardiac surgery and the important role of the perfusionist in running the test and assisting with the interpretation of the results.

Cardiac surgery is a complex and demanding procedure that often requires the use of blood products and other therapies to manage blood loss and ensure optimal patient outcomes. The traditional methods of monitoring coagulation, such as partial thromboplastin time (PTT) and prothrombin time (PT), provide only limited information about the coagulation process. TEG, on the other hand, provides a more comprehensive and dynamic picture of the coagulation process, measuring the time it takes for a blood sample to form a clot, the strength of the clot, and the rate at which the clot dissolves. This information is critical in guiding the use of blood products and other coagulation-altering therapies, helping to minimize blood loss and reduce the risk of transfusion-related complications.

The perfusionist is a highly skilled healthcare professional who is responsible for the management of the cardiopulmonary bypass machine and other aspects of cardiac surgery. During a TEG test, the perfusionist is responsible for collecting a blood sample, preparing the sample for analysis, and running the test using a TEG machine. The TEG machine uses a small rotating pin to monitor the formation and stability of a clot, producing a TEG trace that provides a real-time evaluation of the patient's coagulation status.

Once the TEG test is complete, the perfusionist must assist with the interpretation of the results. This involves analyzing the TEG trace to determine the patient's coagulation status, and using this information to guide the use of blood products and other coagulation-altering therapies. The perfusionist must also be knowledgeable about the normal TEG parameters for a patient undergoing cardiac surgery, as well as the various factors that can affect coagulation, such as anticoagulant and antiplatelet medications, and bleeding.

In addition to its role in blood conservation, TEG can also be used to monitor the effects of anticoagulant and antiplatelet medications, as well as other therapies that alter the coagulation process. The perfusionist must be familiar with the various medications and therapies that can affect coagulation and must be able to adjust the use of these medications and therapies as needed based on the TEG results.

The use of TEG in cardiac surgery has been shown to have numerous benefits, including a reduction in the need for blood transfusions and a decrease in the risk of transfusion-related complications. TEG has also been shown to improve patient outcomes, as it provides a more comprehensive and real-time evaluation of the coagulation process, allowing the surgeon to make more informed decisions about the management of blood loss and coagulation-altering therapies.

In conclusion, Thromboelastography (TEG) is a valuable tool in the management of blood conservation during cardiac surgery. The perfusionist plays a critical role in running the test and assisting with the interpretation of the results, enabling the surgeon to optimize the use of blood products, minimize blood loss, and reduce the risk of transfusion-related complications. The use of TEG has been shown to improve patient outcomes and is becoming