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Percutaneous Hepatic Perfusion (PHP) with Melphalan as a Treatment for Unresectable Metastases Confined to the Liver
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Published on: July 31, 2016

Management of Dilutional Coagulopathy during Pediatric Major Surgery

Thorsten Haas1, Jacqueline Mauch, Markus Weiss

  • 1Department of Anaesthesia, University Children's Hospital Zurich, Switzerland.

Transfusion Medicine and Hemotherapy : Offizielles Organ Der Deutschen Gesellschaft Fur Transfusionsmedizin Und Immunhamatologie
|June 7, 2012
PubMed

Insights

Perioperative dilutional coagulopathy in children is poorly understood, with complex clot firmness disturbances observed. Coagulation factor management may be superior to fresh frozen plasma for effective treatment.

Area of Science:

  • Anesthesiology
  • Pediatric Surgery
  • Hematology

Background:

  • Perioperative dilutional coagulopathy is a significant concern in both adult and pediatric surgery.
  • While underlying mechanisms are similar, specific data on pediatric dilutional coagulopathy is limited.
  • Intraoperative coagulation issues in children often involve complex clot firmness disturbances, including fibrinogen and factor XIII deficiencies.

Purpose of the Study:

  • To highlight the scarcity of data on pediatric dilutional coagulopathy.
  • To emphasize the potential value of advanced coagulation monitoring like thrombelastometry.
  • To discuss alternative management strategies beyond fresh frozen plasma.

Main Methods:

  • Observational data analysis of intraoperative coagulation disorders in pediatric patients.
  • Review of current guidelines and literature on coagulopathy management.
  • Discussion of diagnostic tools such as thrombelastometry.

Main Results:

  • Pediatric intraoperative coagulation disorders are characterized by disturbances in clot firmness.
  • Clotting time and platelet counts tend to remain relatively stable.
  • Acquired deficiencies in fibrinogen and factor XIII are key findings.

Conclusions:

  • Thrombelastometry offers valuable real-time monitoring for effective coagulation management.
  • Coagulation factor administration may be a superior alternative to fresh frozen plasma.
  • Further research is essential to establish optimal modern coagulation management strategies in children.

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