Identification of a thromboelastographic pattern in children undergoing cardiac surgery with prolonged exposure to cardiopulmonary bypass

Abstract

BackgroundPoint-of-care thromboelastography is used for guiding peri-operative haemostatic therapy. ObjectiveTo identify a thromboelastographic pattern in children with prolonged cardiopulmonary bypass exposure. Material and methodsA cohort study of 62 patients undergoing prolonged cardiopulmonary bypass was performed. Patients with preexisting coagulopathy, use of drugs known to interfere with clotting, hematocrit>60%, weight<3kg, or hepatic disease were excluded. The thromboelastography study was conducted at the point of care. ResultsBaseline and rewarming reaction time values were 8.24±6.35 and 7.66±2.15min, respectively (p=0.102). Baseline and rewarming angle values were 64.88±13.08 and 54.67±8.98 degrees, respectively (p<0.001). Baseline and rewarming maximum amplitude values were 64.54±12.31 and 43.14±12.47mm, respectively (p=0.001). The same trend was observed when the cohort was divided into patients under and over 3 years of age, and patients under and over 10kg of body weight. DiscussionThis study suggests the existence of a thromboelastographic pattern independent of age or weight in patients undergoing paediatric cardiac surgery with prolonged cardiopulmonary bypass exposure, characterised by a reduction of angle and maximum amplitude values, with no change in reaction time.