Related Experiment Video
Updated: Jul 9, 2026
Leveraging Turbidity and Thromboelastography for Complementary Clot Characterization
Published on: June 4, 2020
Reference values for kaolin-activated thromboelastography in healthy children
Kah-Lok Chan1, Robyn G Summerhayes, Vera Ignjatovic
1Department of Clinical Hematology, Royal Children's Hospital, Melbourne, Australia.
Insights
Establishing age-specific reference values for kaolin-activated thromboelastography (TEG) in children is crucial for accurate interpretation of coagulation status. This study provides these essential pediatric TEG values for clinical use.
Area of Science:
- Pediatric Hematology
- Coagulation Science
- Point-of-Care Testing
Background:
- Pediatric hemostasis differs significantly from adults, necessitating age-specific reference values.
- Thromboelastography (TEG) offers valuable point-of-care assessment for coagulopathies, especially post-cardiac surgery.
- Current interpretation challenges exist due to a lack of established pediatric TEG norms.
Purpose of the Study:
- To establish age-specific reference values for kaolin-activated TEG in healthy children.
- To facilitate accurate interpretation of TEG in pediatric patients.
- To provide a basis for managing coagulopathies in children.
Main Methods:
- Kaolin-activated TEG performed on 100 healthy children (1 month to 16 years) and 25 adults.
- Key TEG variables measured: reaction time, coagulation time, alpha angle, maximum amplitude, percentage lysis, and coagulation index.
- Analysis of variance used to compare age groups.
Main Results:
- Age-specific reference values for kaolin-activated TEG in children (1 month to 16 years) are presented.
- No significant differences were observed between pediatric and adult TEG values in this study.
- The data provides a foundational set of normal values for pediatric thromboelastography.
Conclusions:
- TEG results require comparison with age-specific, analyzer-specific, and activator-specific reference values for accurate interpretation.
- The provided reference values are valuable for acute clinical settings requiring rapid hemostasis monitoring in children.
- This research supports the clinical utility of TEG in pediatric hemostasis management.
Background:
The hemostatic system of children changes with age and differs significantly from the hemostatic system of adults. Age-specific reference values are therefore required for most hemostatic variables. Thromboelastography (TEG) is a point-of-care coagulation test that may provide superior evaluation and management of coagulopathies after cardiac surgery, when large-dose unfractionated heparin is administered for cardiopulmonary bypass. In this study, we established reference values for kaolin-activated TEG in healthy children, to facilitate accurate interpretation of pediatric TEG results.
Methods:
Kaolin-activated TEG was performed on 100 healthy children undergoing elective day surgery and 25 healthy adult volunteers. The following TEG variables were recorded: reaction time, coagulation time, alpha angle, maximum amplitude, percentage lysis 30 min after maximum amplitude was reached, and the coagulation index. Differences between age-groups were evaluated using analysis of variance.
Results:
Age-specific reference values for kaolin-activated TEG in healthy children between 1 mo and 16 yr of age are presented. No significant differences between children and adults were observed.
Conclusions:
TEG results, from a particular clinical setting, must be compared to age-specific, as well as analyzer- and activator-specific, reference values to allow for correct interpretation of the results. Reference values provided here will be of use in acute clinical situations where a practical monitor of hemostasis is required.
