Tissue factor-activated thromboelastograms in children undergoing cardiac surgery: baseline values and comparisons

Area of Science:

• Pediatric Anesthesiology
• Hemostasis and Thrombosis
• Coagulation Diagnostics

Background:

• Thromboelastography (TEG) is crucial for assessing blood coagulation.
• Tissue factor (TF)-activated TEG offers rapid evaluation but requires age-specific baseline data.
• Pediatric cardiac surgery patients often present with complex coagulopathies.

Purpose of the Study:

• To establish baseline values for TF-activated TEG in infants and young children (<2 years) undergoing cardiac surgery.
• To analyze the impact of age on TF-activated TEG variables in this population.
• To provide data for improved interpretation and clinical application of TF-activated TEG in pediatric patients.

Main Methods:

• TF-activated TEG was performed on 250 children younger than 2 years undergoing cardiac surgery.
• Participants were categorized into five age groups: <30 days, 1-3 months, 3-6 months, 6-12 months, and 12-24 months.
• Coagulation variables including R, K, alpha, and maximum amplitude were analyzed.

Main Results:

• Activation of clotting (R and K values) and fibrinolysis were similar across all age groups.
• Infants aged 1-3 months showed increased clot strength compared to other groups.
• Alpha and maximum amplitude values were remarkably consistent across all age groups, facilitating faster interpretation.

Conclusions:

• Established baseline TF-activated TEG values are crucial for accurate interpretation in young children.
• These data support the use of TF-activated TEG in managing coagulopathies in pediatric cardiac surgery.
• The consistency of alpha and maximum amplitude simplifies rapid assessment in this demographic.