Comparison of conventional and automated thromboelastography

Abstract

Summary. Introduction. Automated thromboelastography systems remain relatively new in routine clinical practice, and confidence in the validity of their results continues to be a subject of scrutiny. Aim: to perform a comparative analysis of thromboelastographic data obtained from Haema TX automated thromboelastograph (MedCaptain, China) and the conventional TEG 5000 system (Haemonetics, USA). Materials and Methods. The study was conducted from June 2024 to March 2025 at the Department of Laboratory Diagnostics of the Russian Center of Neurology and Neurosciences. The TEG 5000 (Haemonetics) served as the reference instrument. Whole venous blood was used as the analytical matrix. Each of the 50 samples was evaluated for a range of coagulation and platelet function parameters. Native-TEG (non-activated) assays were performed simultaneously on two channels of each device to ensure synchronous measurement. Statistical analysis included descriptive measures (median [Q1; Q3]), and group comparisons were conducted using the non-parametric Wilcoxon signed-rank test. The impact of standard coagulation markers and platelet aggregation indices on thromboelastographic values was assessed via linear regression and Spearman’s rank correlation. Statistical significance was defined as p < 0.05. Results. Paired intra-device comparisons revealed only one statistically significant discrepancy specifically, the R time on the Haema TX. When comparing the two analyzers, a statistically significant difference was observed in the Angle α on channel 1 (p = 0.0354). On channel 2, both the Angle α and LY30 differed significantly (p = 0.0308 and p = 0.0232, respectively). However, when channel data were averaged within each analyzer, only the Angle α remained significantly different between systems (p = 0.0274). The strongest correlations emerged between thromboelastographic parameters and platelet aggregation, independent of the agonist used (epinephrine or ADP). In contrast, no meaningful correlation was seen between TEG values and conventional plasma coagulation tests. For the Haema TX, maximum amplitude (MA) demonstrated a robust positive correlation with platelet aggregation induced by either agonist, while R time exhibited a moderate inverse relationship. Conclusion. Both instruments demonstrated high sensitivity to platelet aggregation activity in the context of native-TEG. While some statistically significant differences were observed particularly for R and the Angle α, these differences fell well within the expected analytical variability and are unlikely to bear clinical consequence. Of note is that TEG, as a point-of-care (РОС) modality, is not intended to deliver rigid numerical targets. Its purpose is rather to facilitate timely, physiology-guided decision-making modulating the patient’s hemostatic potential in accordance with the evolving clinical scenario, rather than adhering to predefined laboratory thresholds. From this perspective, the Haema TX appears analytically and clinically adequate for bedside coagulation management.

For citation: Roitman E.V., Shabalina A.A., Tanashyan M.M., Dmitrieva N. Yu. Comparison of conventional and automated thromboelastography. Tromboz, gemostaz i reologiya. 2026;(1):93–100. (In Russ.).

References 

1. Bulanov A. Yu. Thromboelastography in modern clinical practice: atlas TEG. Moscow: N’yudiamed, 2015. 114 pp. (In Russ.).

2. National standard of the Russian Federation GOST R 59778–2021 “Procedures for Taking Venous and Capillary Blood Samples for Laboratory Research” (approved and implemented by Order N 1212-st of the Federal Agency for Technical Regulation and Metrology dated October 21, 2021 N 1212-st). Moscow, 2021. 30 pp. (In Russ.). Available at: https://mos-medsestra.ru/biblioteka/ gost/2_5422660334508840711.pdf. [Accessed: 15.08.2024].

3. Order N 464n of the Ministry of Health of the Russian Federation dated of May 18, 2021 “On approval of the Rules for conducting laboratory tests” (as amended and supplemented on November 23, 2021). Moscow, 2021. 53 pp. (In Russ.). Available at: https:// base.garant.ru/400839855/?ysclid = lzgt8kgewo630507380. [Accessed: 15.08.2024];

4. Resolution N 4 of the Chief Public Health Officer of the Russian Federation dated 28.01.2021 “On Approval of Sanitary Rules and Norms SanPiN 3.3686–21 “Sanitary and Epidemiological Requirements for the Prevention of Infectious Diseases” (together with SanPiN 3.3686–21. Sanitary rules and regulations...) (Registered with the Ministry of Justice of Russia under N 62500 on 15.02.2021). Moscow, 2021. 957 pp. (In Russ.). Available at: http:// vnipchi.rospotrebnadzor.ru/s/203/files/ND/safety/95493_64.pdf. [Accessed: 15.08.2024].