TEG 6s Coagulation Guide
Interpret thromboelastography (TEG 6s) results and identify targeted coagulation therapy. Differentiate heparin effect from factor deficiency and guide goal-directed hemostatic management.
Based on: ESC 2022 · ESAIC
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Overview
Thromboelastography (TEG 6s) provides real-time viscoelastic assessment of whole-blood coagulation at the bedside. By measuring clot formation continuously, TEG captures the entire haemostatic process — from initial thrombin generation through clot strength and fibrinolysis. This tool focuses on five key TEG 6s parameters — CK-R, CKH-R, CRT-MA, CFF-MA, and LY30 — which together map the major physiological phases of haemostasis: clot initiation, clot strength, and fibrinolysis.
Evidence Summary
Multiple randomised trials and meta-analyses demonstrate that viscoelastic haemostatic assay (VHA)-guided transfusion reduces allogeneic blood product use without increasing mortality or thromboembolic events. Evidence is strongest in cardiac surgery and trauma haemorrhage. ITACTIC (2021) compared VHA-augmented protocols with conventional coagulation tests in trauma: while the primary endpoint was not met in the overall population, VHA protocols reduced 24-hour blood product use. A 2015 Cochrane review (Whiting et al.) confirmed that point-of-care viscoelastic testing reduces red cell transfusion compared with standard laboratory tests. Compared with PT/APTT/fibrinogen, TEG provides faster turnaround and reflects global haemostatic function under near-physiological conditions.