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Author Spotlight: Deciphering Coagulation Disorders in Traumatic Brain Injury Patients
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Trauma induced hypercoagulablity in pediatric patients

Mark L Ryan1, Robert M Van Haren1, Chad M Thorson1

  • 1Dewitt-Daughtry Department of Surgery, Divisions of Trauma and Surgical Critical Care, University of Miami Miller School of Medicine, Miami, FL 33136, USA.

Journal of Pediatric Surgery
|August 6, 2014
PubMed

Insights

Pediatric trauma induces a hypercoagulable state, characterized by accelerated clotting and elevated markers like d-dimer. Further research is needed to understand the clinical significance and establish pediatric reference ranges for coagulation factors.

Area of Science:

  • Pediatric hematology
  • Trauma critical care
  • Hemostasis and thrombosis

Background:

  • Coagulation changes in pediatric trauma are not well understood.
  • Existing adult reference ranges may not apply to children.

Purpose of the Study:

  • To investigate coagulation alterations in pediatric trauma patients.
  • To test the hypothesis that trauma induces a hypercoagulable state in children.

Main Methods:

  • Prospective observational study of hospitalized children (8 months to 14 years).
  • Coagulation assessed using thromboelastography (TEG) and clotting factor assays.
  • Comparison between trauma patients and uninjured controls.

Main Results:

  • Trauma patients showed significantly higher prothrombin time (PT) and accelerated TEG clotting time and fibrin cross-linking.
  • Elevated d-dimer, Prothrombin Fragment 1+2, and Plasminogen Activator Inhibitor-1 were observed in trauma patients.
  • Reduced Protein S activity and a high proportion of abnormal TEG/clotting factor values in pediatric controls compared to adult ranges.

Conclusions:

  • Minor trauma in children is associated with a hypercoagulable state.
  • Further investigation is required to determine the functional significance of these findings.
  • Establishing normal pediatric reference ranges for coagulation parameters is essential.
Abstract

Keywords:
CoagulationPediatricThromboelastographyTrauma

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