Abstract

TAMARIZ-CRUZ, Orlando J. et al. Identification of a thromboelastographic pattern in children undergoing cardiac surgery with prolonged exposure to cardiopulmonary bypass. Rev. colomb. anestesiol. [online]. 2017, vol.45, n.2, pp.108-113. ISSN 0120-3347.

Background: Point-of-care thromboelastography is used for guiding peri-operative haemostatic therapy. Objective: To identify a thromboelastographic pattern in children with prolonged cardiopulmonary bypass exposure. Material and methods: A 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 < 3 kg, or hepatic disease were excluded. The thromboelastography study was conducted at the point of care. Results: Baseline 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 ± 12.47 mm, 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 10 kg of body weight. Discussion: This 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.

Keywords : Thrombelastography; Thoracic surgery; Hemorrhage; Child; Blood Coagulation.

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