[HSF] Aprotinin and TEG

[Michael Firstenberg]

Don,
We have been using TEGs more and more to manage anticoag in our VAD  
patients and have been very happy with the results.  I thought the  
strength was measuring the effects of ASA/Plavix.  Why do you feel  
that it is unreliable pre-op?


-michael


On Nov 20, 2006, at 3:43 AM, Donald Ross wrote:

> Just a word on aprotinin and platelet poisons.
> We have the latest TEG machine and have found it to be unreliable  
> for diagnosing platelet dysfunction prior to surgery in cases dosed  
> up with aspirin or clopidogrel.
> I use the very cheap eyeball test of the state of bleeding prior to  
> heparin. We all know what a coagulopathy looks like clinically  
> after the sternum has been split. I only use aprotinin in this  
> situation if I make the diagnosis clinically. The TEG has false  
> positive and negative errors according to clinical bleeding  
> associated with clopidogrel.
> This is not to denigrate its use for diagnosis in post op  
> coagulopathy.
> Don
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