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Our institution considered TEG for years, but implementation of a very active strategic blood management program a couple of years ago made this an imperative for the institution. In the past year, new surgeons (esp. intraabdominal tx) have come on board looking for this technique to help monitor parameters as Dr. Stickle described. Collaborating with anesthesiologists in OR, our blood utilization committee, the surgeons and our department, we decided to implement ROTEM which is a slightly different analytical technique from TEG, but provides much of the same clinical information. In conjunction with recent FDA approvals of a couple of the methods, we're in the final stages of validations for instruments in the OR Lab and Core Lab. Our staff find it very interesting to use. Kind of a 'cool' concept for a clinical biochemist like me. But its use absolutely requires the buy in and support from key clinicians - especially in the anesthesiology and surgical groups. Steve Kahn, Ph.D. Loyola University Health System Maywood, IL, USA
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