Hemostasis is a dynamic, complicated process that involves many interacting components. As a result, during activation no factor remains static or works in isolation. The TEG® Thrombelastograph® Hemostasis Analyzer is unique in its ability to detect the state, cause, and extent of imbalance in patient hemostasis and to provide guidance for effective treatment. The TEG system is comprised of an analyzer and analytic software which together provide a complete picture of the formation and dissolution of blood clots.

A BALANCING ACT

What is hemostasis?
One definition of normal hemostasis is provided by Laposata et al. "Normal hemostasis is the capability of the hemostatic system to control activation of clot formation and clot lysis in order to prevent hemorrhage without causing thrombosis." This definition shows that:

1. There are two systems involved simultaneously in hemostasis: the procoagulant system and the fibrinolytic system.
2. The presence or absence of hemorrhage or thrombosis depends on a delicate balance between these two systems. Excess procoagulants will result in thrombosis; too much activation of the fibrinolytic system will result in hemorrhage.
3. Any system that measures hemostasis without measuring the balance between the two systems is not able to provide accurate information on patient hemostasis and, in fact, may provide misleading information.

The complexity in hemostasis
Hemostasis is a dynamic, extremely complex process, involving many interacting factors, which include coagulation and fibrinolytic proteins, activators, inhibitors and cellular elements such as platelet cytoskeleton, platelet cytoplasmic granules, and platelet cell surfaces. As a result, during activation, no factor remains static or works in isolation. The standard laboratory tests are isolated plasma tests that ignore the role of platelets in patient hemostasis and their interaction with coagulation protein at a particular point in time.

Balance is everything
Envision the delicate balance…The TEG Thrombelastograph Hemostasis Analyzer provides a complete picture of all phases of patient hemostasis, right at the point of care. This "total picture" of hemostasis - prothrombotic and hemorrhagic -- displays the balance or imbalance in the hemostasis system, highlights areas of deficiency or excess, and offers a precise view of the hemostasis landscape. The TEG system delivers an analysis that is more comprehensive and complete than isolated, static conventional tests.

BALANCING THE SYSTEMS

In a majority of pathologies and surgical procedures, a shift occurs in the hemostasis balance between the prothrombotic and hemorrhagic states, and identifying and monitoring the shift between the two states is important under all these conditions. Furthermore, in some circumstances, being able to control the degree of shift can make a critical difference in outcome -- for example, consider the case of using artificial surface devices, where it is beneficial to keep the patient in a slightly anti-coagulated state.

Armed with this information, and using the TEG-guided hemostasis and blood management strategy, clinicians can make better diagnostic and therapeutic decisions.

For more information on the TEG system, click on the links below:

• Product Brochure
• Spec Sheet
• Operational Graphic (1)
• Operational Graphic (2)
• Clinical References

For a review of a decision tree, and the patterns seen in TEG tracings, click here.

For additional detailed information about the TEG system, place visit www.haemoscope.com