Thromboelastography: past, present, and future.

THIS issue of ANESTHESIOLOGY contains an article by Camenzind et al. regarding the influence of citrate storage on thromboelastography (TEG Haemascope Corp.). Although the TEG is most commonly performed on a native (uncitrated) sample, the use of citrated blood permits longer delays after sample acquisition, thus facilitating ancillary or research laboratory analysis. Camenzind et al. nicely outline some of the issues related to the impact of sample storage on the TEG. Anesthesiology, as a specialty, has taken a leading role in evaluating the TEG as a nearsite monitor of hemostasis in several clinical settings. Many issues, however, remain unresolved about how to use the TEG to guide clinical decision-making. The purpose of this Editorial View is to briefly review studies that have lead to current applications of the TEG and to outline future challenges that need to be addressed for its broader use.