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Original Research

Open Access

Thromboelastometry in neonates and infants undergoing cardiac surgery

  • GORAZD KALAN1
  • ENVER MELKIC2
  • MOJCA GROSELJ-GRENC1

1,Department of Paediatric Surgery and Intensive Care University Medical Centre

2Institute of Clinical Chemistry and Biochemistry, University Medical Centre

DOI: 10.22514/SV82.102013.6 Vol.8,Issue 2,October 2013 pp.37-41

Published: 17 October 2013

*Corresponding Author(s): MOJCA GROSELJ-GRENC E-mail: mojca.groselj@kclj.si

Abstract

Introduction. Rotational thromboelastometry (ROTEM) in monitoring coagulation in children undergoing cardiac surgery has been studied with promising results. Since the data about ROTEM in infants and neonates undergoing cardiac surgery are scarce, the aim of our study was to asses ROTEM abnormalities in this patient group.

Methods. Infants and neonates undergoing cardiac surgery on cardiopulmonary bypass were included in this prospective, observational study conducted in a level III multidisciplinary neonatal and pediatric intensive care unit (ICU) between May 2011 and January 2012. ROTEM analysis, together with determination of platelet count, international normalized ratio of prothrombin time (INR), activated partial thromboplastin time (PTT), and fibrinogen concentration, was done in all neonates 

and infants before surgery (t1), after admission to ICU (t2) and 24 hours after surgery (t3).

Results. Twenty infants and neonates were operated on during the time of the study. ROTEM abnormalities seen after sur-

gery (t2) were: thrombocytopenia 14, hypofibrinogenemia 1, mixed hypofibrinogenemia and coagulation factor deficiency 1, and mixed thrombocytopenia with mild hyperfibrinolysis 1. Three patients were found to have normal ROTEM results. The median values of all except one of the ROTEM tests, as well as platelet count, INR, PTT, and fibrinogen concentration, showed significant prolongation or deterioration after admission to ICU and these deteriorations persisted in several para-meters for 24 hours.

Conclusions. In our neonates and infants, cardiac surgery on cardiopulmonary bypass predominantly affects platelets, although most of the ROTEM parameters deteriorated after admission to ICU. 

Keywords

thromboelastometry, car-diac surgery, neonate, infant, throm-bocytopenia, hypofibrinogenemia

Cite and Share

GORAZD KALAN,ENVER MELKIC,MOJCA GROSELJ-GRENC. Thromboelastometry in neonates and infants undergoing cardiac surgery. Signa Vitae. 2013. 8(2);37-41.

References

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