Author: Adelmann D et al.
Anesthesiology, September 18, 2025. doi:10.1097/ALN.0000000000005759
This multicenter observational study evaluated the TEG® 6s Global Hemostasis – Heparin Neutralization cartridge, newly cleared by the FDA, in patients undergoing cardiovascular surgery with cardiopulmonary bypass (CPB) or other invasive cardiac procedures requiring unfractionated heparin.
A total of 543 blood samples from 185 patients were analyzed. Comparisons between the Heparin Neutralization cartridge and the established Citrated Multichannel cartridge showed strong agreement, with Deming regression slopes near 1.0 and correlation coefficients between 0.79 and 0.96. The functional fibrinogen with heparinase assay moderately correlated with Clauss fibrinogen levels (Spearman r = 0.68). Importantly, the addition of heparinase improved analyzability of RapidTEG™ and functional fibrinogen assays, increasing their clinical utility in heparinized settings.
This validation demonstrates that the Heparin Neutralization cartridge provides reliable point-of-care coagulation testing in heparinized cardiovascular patients. However, outcome-based prospective trials are needed to confirm its impact on clinical decision-making and patient outcomes.
What You Should Know
• The TEG® 6s Heparin Neutralization cartridge neutralizes heparin effects, allowing accurate coagulation testing in cardiovascular surgery.
• Strong agreement with the established Citrated Multichannel cartridge was observed across assays.
• Functional fibrinogen with heparinase correlated with plasma fibrinogen levels.
• Adding heparinase increased the proportion of interpretable RapidTEG™ and fibrinogen results.
• Clinical validation is established, but outcome-based trials are needed before widespread adoption.
Thank you to Anesthesiology for making this study available.