Predictive Value of Thromboelastography for Postoperative Blood Loss in Infants Undergoing Cardiac Surgery

Abstract

Thromboelastography (TEG) has emerged as a critical tool in promptly identifying the risk of postoperative bleeding, especially in infants and young children undergoing cardiac surgery. By meticulously analyzing TEG parameters, clinicians gain a profound understanding of patients' coagulation status, enabling timely intervention to minimize and manage postoperative bleeding risks. The present study adopts a rigorous, prospective, and observational approach to explore the relationship between intraoperative TEG test results and postoperative blood loss. Furthermore, it aims to assess the potential of intraoperative TEG testing as an early predictor of postoperative bleeding in high-risk pediatric patients. In this process, a key focus is placed on perioperative red blood cell suspension and platelet transfusion volume, as well as their association with TEG testing outcomes. Our findings reveal a significant correlation between the volume of red blood cell suspension and platelet transfusion and the MA value derived from TEG testing. The MA value, a pivotal indicator in TEG test results, represents the maximum clotting strength. Notably, during perioperative red blood cell suspension and platelet transfusion, the MA value often exhibits corresponding changes. These changes not only reflect improvements in coagulation function but also provide clinicians with an objective basis for evaluating the effectiveness of blood transfusion. However, despite the notable impact of blood transfusion on MA values, our study did not detect statistically significant associations between blood transfusion and other TEG parameters, including TEG-ACT values, α-Angle, and LY30. This absence of significant associations may be attributed to the differential effects of various transfusion components on the coagulation process, as well as the influence of confounding factors such as patient age, comorbidities, and surgical procedure type.