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Sonoclot analysis in healthy children
E G Pivalizza1, P J Pivalizza, S Kee
1Department of Anesthesiology, University of Texas Health Science Center, Houston 77030, USA. Evan.G.Pivalizza@uth.tmc.edu
Insights
This study establishes normal Sonoclot device ranges for healthy pediatric surgical patients. These findings provide crucial data for accurate coagulation management in children, avoiding adult data extrapolation.
Area of Science:
- Pediatric Coagulation
- Hemostasis Monitoring
- Medical Device Validation
Background:
- Limited data exists for Sonoclot device use in normal pediatric patients.
- The Sonoclot device is utilized in critical pediatric surgeries involving coagulation abnormalities.
- Establishing pediatric-specific normal ranges is essential for accurate clinical interpretation.
Purpose of the Study:
- To determine normal data ranges for Sonoclot variables in healthy pediatric surgical patients.
- To compare Sonoclot measurements across different pediatric age groups and adults.
- To provide a basis for improved coagulation management in pediatric care.
Main Methods:
- Blood samples were collected from 95 healthy pediatric surgical patients post-anesthetic induction.
- Sonoclot activated clotting time, clot formation rate, time to peak amplitude, and peak amplitude were measured.
- Data were analyzed and compared across four pediatric age groups (<12 mo, 13-24 mo, 25-48 mo, 49 mo-9 yr) and an adult group.
Main Results:
- Sonoclot activated clotting time differed significantly between the <12-month group and the oldest pediatric group, and between adults and the oldest pediatric group.
- All measured Sonoclot activated clotting times fell within anticipated normal ranges.
- No significant differences were observed in clot formation rate, time to peak amplitude, or peak amplitude across the age groups.
Conclusions:
- This study presents the first published Sonoclot variables for healthy pediatric surgical patients.
- The established pediatric normal ranges facilitate accurate clinical coagulation management.
- These findings help avoid the application of extrapolated adult data to pediatric patients, improving care.
Unlabelled:
Although use of the Sonoclot device (Sienco, Inc., Morrison, CO) has been reported in isolated pediatric cases and in small reports in neonates, there are no published data for normal pediatric patients. As the device is used in situations of abnormal coagulation, such as cardiac and liver transplantation surgery, our aim was to determine normal data ranges in healthy pediatric surgical patients. Blood was withdrawn after anesthetic induction, and the Sonoclot activated clotting time, rate of clot formation, time to peak amplitude, and peak amplitude was compared among four pediatric groups (< 12 mo, 13-24 mo, 25-48 mo, 49 mo-9 yr) and an adult group. The Sonoclot activated clotting time in the < 12-mo and the Adult groups were shorter than the oldest group of children (P < 0.05), although all were within the anticipated normal range, and there were no significant differences in clot rate, peak amplitude, and time to peak amplitude among groups without apparent trends with increasing age. These Sonoclot variables quantify adequate global clot formation in pediatric patients and will facilitate clinical coagulation management with appropriate pediatric normal ranges, avoiding the application of extrapolated adult data to children.
Implications:
Sonoclot variables are presented for 95 healthy pediatric surgical patients in four age groups, with small differences found in the Sonoclot (Sienco, Inc., Morrison, CO) activated clotting time between two groups and no significant differences in three other variables among groups.