Why is everyone so excited about thromboelastrography (TEG)?

Thromboelastrography (TEG) is one of the most common whole-blood viscoelastic coagulation tests used in clinical laboratories and at the point of care. TEG provides information on coagulation defects that are often difficult to detect using routine laboratory tests such as activated partial prothrombin time or prothrombin time. In certain critically ill patient populations, the use of TEG instead of or in addition to routine laboratory coagulation tests has been shown to improve outcomes or reduce transfusion requirements. However, TEG and other viscoelastic coagulation tests are affected by unique pre-analytic and analytic variables that do not impact other common laboratory coagulation tests. In this review the underlying principles, clinical applications, and laboratory aspects of TEG testing are discussed.