Monitoring Viscoelastic Blood Properties during Pediatric Cardiac Surgery: The Challenge of Data Driven Hemostasis

Zhe Fang,Sitaram Emani,Juan Ibla,Meena Nathan,Sirisha Emani

doi:10.29245/2578-2940/2020/2.1158

Abstract

Monitoring Viscoelastic Blood Properties during Pediatric Cardiac Surgery: The Challenge of Data Driven Hemostasis

Highlights

Thromboelastography provides a graphical representation of the activation of coagulation and fibrin polymerization process and was first described by Hartert in 19481
Kim and colleagues studied the rotational thromboelastometry (ROTEM) reference values for pediatric patients of different age groups up to the age of 16 years with congenital heart disease[11]. They demonstrated that the EXTEM in patients less than 3 months of age had shorter clotting time (CT), clot formation time (CFT), steeper alpha angle, and greater maximum clot firmness (MCF) and amplitude at 10 min (A10)
Romlin and colleagues found intraoperative ROTEM use was associated with less transfusion of red blood cell (RBC) and fresh frozen plasma (FFP), but more platelets and cryoprecipitate in pediatric patients undergoing cardiac surgery in a prospective cohort study compared to historical controls[21]

Summary

Introduction

Thromboelastography provides a graphical representation of the activation of coagulation and fibrin polymerization process and was first described by Hartert in 19481. There has been increased interest in incorporating TEG and ROTEM testing in pediatric cardiac surgery patients to detect defects in coagulation and guide transfusion. The evidence for its use in pediatric cardiac surgery, and the ability for the system to detect potential coagulopathy and thrombotic complications.

Results

Conclusion