thromboelastography (TEG)

^[1]^[2]

Indications

may have a role in guiding fresh frozen plasma use in trauma
may have role as point of care test to assess eligibility in patients taking direct oral anticoagulants (DOAC) for thrombolysis for ischemic stroke (not yet a validated measure)^[2]

↑ ^1.0 ^1.1 N Engl J Med Journal Watch. Jan 24, 2014. Massachusetts Medical Society http://www.jwatch.org
McCully SP, Fabricant LJ, Kunio NR et al The International Normalized Ratio overestimates coagulopathy in stable trauma and surgical patients. J Trauma Acute Care Surg. 2013 Dec;75(6):947-53. PMID: https://www.ncbi.nlm.nih.gov/pubmed/24256665
↑ ^2.0 ^2.1 ^2.2 Lou N Holding tPA for All DOAC Users Not the Way to Go, Stroke Docs Say. Clinical conundrum could be solved by a point-of-care DOAC test. MedPage Today March 15, 2021 https://www.medpagetoday.com/neurology/strokes/91633
Seiffge DJ, Wildon D, Wu TYH et al Administering thrombolysis for acute ischemic stroke in patients taking direct oral anticoagulants: to treat or how to treat. JAMA Neurol 2021. March 15 PMID: https://www.ncbi.nlm.nih.gov/pubmed/33720313 https://jamanetwork.com/journals/jamaneurology/article-abstract/2777622
Czap AL, Grotta JC Complexities of reperfusion therapy in patients with ischemic stroke pretreated with direct oral anticoagulants: to treat or not, and how? JAMA Neurol 2021 PMID: https://www.ncbi.nlm.nih.gov/pubmed/33720276 https://jamanetwork.com/journals/jamaneurology/article-abstract/2777623