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TEG® Functional Fibrinogen Analysis May Overestimate Fibrinogen Levels

Ågren, Anna MD, PhD*†; Wikman, Agneta Taune MD, PhD‡§; Östlund, Anders MD, PhD; Edgren, Gustaf MD, PhD¶*

doi: 10.1213/ANE.0000000000000172
Cardiovascular Anesthesiology: Brief Report

Fibrinogen is of crucial importance in patients with ongoing bleeding. In this study, we compared fibrinogen concentration measured by thrombelastography (TEG®) with fibrinogen plasma concentration determined by Clauss. Sixty-three surgical patients and 38 healthy controls were included. For the whole group (patients and controls, n = 101), TEG® functional fibrinogen was on average 1.0 g/L higher than the plasma fibrinogen concentration (3.5 vs 2.5 g/L, 95% confidence interval for difference 0.8 to 1.2 g/L, P < 0.0001). Similar patterns were observed when patients and healthy controls were analysed separately. The fibrinogen level may be overestimated when assessed using TEG® compared with the fibrinogen plasma concentration measured by the conventional method.

From the *Department of Medicine, Division of Hematology, Coagulation Unit, Karolinska University Hospital, Stockholm, Sweden; Department of Clinical Sciences, Karolinska Institutet, Danderyd Hospital, Stockholm, Sweden; Department of Clinical Immunology and Transfusion Medicine, Karolinska University Hospital, Stockholm, Sweden; §Department of Laboratory Medicine, Karolinska Institutet, Stockholm, Sweden; Department of Anesthesiology and Intensive Care, Karolinska University Hospital and Karolinska Institutet, Stockholm, Sweden; and Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden.

Accepted for publication January 28, 2014.

Funding: None. Gustaf Edgren is supported with a grant from Svenska Sällskapet för Medicinsk Forskning (SSMF).

The authors declare no conflicts of interest.

Reprints will not be available from the authors.

Address correspondence to Anna Ågren, MD, PhD, Coagulation Unit, Hematology Center, Karolinska University Hospital, SE-171 76 Stockholm, Sweden. Address e-mail to

© 2014 International Anesthesia Research Society