Disorders of clotting and coagulation are common in the intensive care unit. Diagnosis, treatment and monitoring of these disorders are traditionally based on conventional coagulation tests such as activated partial thromboplastin time (APTT) and international normalised ratio (INR). We present here a patient who developed massive postoperative haemorrhage secondary to an acquired factor VIII inhibitor. The case highlights the utility and sensitivity of thromboelastography (TEG) in the diagnosis of the condition and monitoring the response to therapy.
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