Coagulation abnormalities in the trauma patient: the role of point-of-care thromboelastography

Semin Thromb Hemost. 2010 Oct;36(7):723-37. doi: 10.1055/s-0030-1265289. Epub 2010 Oct 26.


Current recommendations for resuscitation of the critically injured patient are limited by a lack of point-of-care (POC) assessment of coagulation status. Accordingly, the potential exists for indiscriminant blood component administration. Furthermore, although thromboembolic events have been described shortly after injury, the time sequence of post-injury coagulation changes is unknown. Our current understanding of hemostasis has shifted from a classic view, in which coagulation was considered a chain of catalytic enzyme reactions, to the cell-based model (CBM), representing the interplay between the cellular and plasma components of clot formation. Thromboelastography (TEG), a time-sensitive dynamic assay of the viscoelastic properties of blood, closely parallels the CBM, permitting timely, goal-directed restoration of hemostasis via POC monitoring of coagulation status. TEG-based therapy allows for goal-directed blood product administration in trauma, with potential avoidance of the complications resulting from overzealous component administration, as well as the ability to monitor post-injury coagulation status and thromboprophylaxis. This overview addresses coagulation status and thromboprophylaxis management in the trauma patient and the emerging role of POC TEG.

Publication types

  • Review

MeSH terms

  • Blood Coagulation Disorders / blood*
  • Blood Coagulation Disorders / etiology
  • Blood Coagulation Disorders / pathology
  • Humans
  • Point-of-Care Systems*
  • Thrombelastography / methods*
  • Wounds and Injuries / blood*
  • Wounds and Injuries / pathology