Kaolin-activated whole blood thrombelastography (TEG) is an appealing test of coagulation in the perioperative period, because it assesses many aspects of coagulation and can be performed at the point of care. In this issue, Weinberg et al report the use of kaolin-activated TEG as a global assessment of coagulation as part of their investigation of coagulation activation after hepatic resection for cancer1. However, while kaolin-activated TEG assesses many aspects of coagulation, it does not assess all aspects of coagulation, so ‘normal’ findings should be interpreted with caution.
References
1.
WeinbergL., ScurrahN., ParkerF.C., DauerR., MarshallJ., McCallP.Markers of coagulation activation after hepatic resection for cancer: evidence of sustained upregulation of coagulation.Anaesth Intensive Care2011; 39: 5: 847–853.
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HoffmanM., MonroeD.M.A cell-based model of hemostasis.Thromb Hemost2001; 85: 958–965.
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NgV.L.Prothrombin time and partial thromboplastin time assay considerations.Clin Lab Med2009; 29: 253–263.
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GibbsN.M.Point of care assessment of antiplaelet agents in the perioperative period: a review.Anaesth Intensive Care2009; 37: 354–369.
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CraftR.M., ChavezJ.J., BreseeS.J., WorthamD.C., CohenE., CarrollR.C.A novel modification of the thrombelastograph assay, isolating platelet function, correlates well with platelet aggregation.J Lab Clin Med2004; 143: 301–309.
GibbsN.M.Postoperative hypercoagulability: Mechanisms and clinical implications. In: KeneallyJ., JonesM., eds. Australasian Anaesthesia 1994.Melbourne: Australian and New Zealand College of Anaesthetists1994.
