Effect of thrombelastography on the assessment of sepsis severity and septic shock with disseminated intravascular coagulation condition in children

Abstract

Objective To explore the effect of thrombelastography in sepsis and septic shock with disseminated intravascular coagulation (DIC) condition in children. Methods Ninety-one cases of children admitted to the Pediatric Intensive Care Unit, Zhengzhou Children′s Hospital between January 2013 and December 2016 were enrolled in this study.Fifty-eight cases of sepsis, 17 cases of severe sepsis and 16 cases of septic shock (including 7 cases DIC and 9 cases non-DIC) were included in 91 cases of children.After admission, they were given conventional treatment according to their condition of illness, such as expansion of rehydration, applying vascular active drugs, anti-infection, mechanical ventilation, maintaining internal environment, nutrition support, etc.Thrombelastography of all the patients were detected for 6 hours after admission.The test indexes included blood coagulation reaction time (R), blood clot formation time (K) and blood clot formation rate (alpha), maximum width (MA), coagulation index (CI), etc.And pe-diatric critical illness scores(PCIS) were also evaluated for 6 hours after admission. Results With the progression of sepsis severity, R value, K value increased dramatically(F=3.629, 4.237, all P 0.05). Conclusions TEG has a great significance in evaluating severity of children with sepsis.It can also guide clinical assessment in children with septic shock DIC so as to give accurate effective intervention and improve the rescue success rate and the prognosis. Key words: Thrombelastography; Child; Sepsis; Pediatric critical illness score; Disseminated intravascular coagulation