TEG treatment algorithm from Copenhagen
| TEG variables . | Normal range . | Patient value . | Coagulopathy . | Hemostatic therapy . |
|---|---|---|---|---|
| R | 3-9 minutes | 10-14 minutes | Coagulation factors ↓ | FFP 10-20 mL/kg |
| >14 minutes | Coagulation factors ↓↓ | FFP 30 mL/kg | ||
| Angle | 55°-78° | <52° | Fibrinogen ↓ | FFP 20-30 mL/kg |
| Functional fibrinogen MA | 14-27 mm | <14 mm | Fibrinogen ↓ | FFP 20-20 mL/kg or cryoprecipitate pool (3-5 mL/kg) or fibrinogen concentrate (adults 1-2 g) |
| KaolinTEG MA* | 51-69 mm | 45-49 mm | Platelets ↓ | 1 PC or 5 mL/kg |
| <45 mm | Platelets ↓↓ | 2 PC or 10 mL/kg | ||
| KaolinTEG Ly30 | 0-4% | >4% | Primary hyperfibrinolysis | Tranexamic acid (adults 1-2 g) |
| >4% + angle and/or MA ↑ | Reactive hyperfibrinolysis | Tranexamic acids contraindicated | ||
| R in Kaolin/heparinaseTEG | >3-minute difference | Heparinization | Protamin sulfate (adults 50-100 mg) or FFP 10-20 mL/kg |
| TEG variables . | Normal range . | Patient value . | Coagulopathy . | Hemostatic therapy . |
|---|---|---|---|---|
| R | 3-9 minutes | 10-14 minutes | Coagulation factors ↓ | FFP 10-20 mL/kg |
| >14 minutes | Coagulation factors ↓↓ | FFP 30 mL/kg | ||
| Angle | 55°-78° | <52° | Fibrinogen ↓ | FFP 20-30 mL/kg |
| Functional fibrinogen MA | 14-27 mm | <14 mm | Fibrinogen ↓ | FFP 20-20 mL/kg or cryoprecipitate pool (3-5 mL/kg) or fibrinogen concentrate (adults 1-2 g) |
| KaolinTEG MA* | 51-69 mm | 45-49 mm | Platelets ↓ | 1 PC or 5 mL/kg |
| <45 mm | Platelets ↓↓ | 2 PC or 10 mL/kg | ||
| KaolinTEG Ly30 | 0-4% | >4% | Primary hyperfibrinolysis | Tranexamic acid (adults 1-2 g) |
| >4% + angle and/or MA ↑ | Reactive hyperfibrinolysis | Tranexamic acids contraindicated | ||
| R in Kaolin/heparinaseTEG | >3-minute difference | Heparinization | Protamin sulfate (adults 50-100 mg) or FFP 10-20 mL/kg |
Goal-directed TEG-based guideline for hemostatic resuscitation with plasma, platelets, cryoprecipitate pool, fibrinogen concentrate, and tranexamic acid in bleeding patients used at hospitals in the Capital Region of Denmark.
In patients with normal functional fibrinogen MA.