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Thromboelastography--does it impact blood component transfusion in pediatric heart surgery?
Lauren C Kane1, Cathy S Woodward2, Syed Adil Husain1
1Department of Cardiothoracic Surgery, University of Texas Health Sciences Center San Antonio, San Antonio, Texas.
The Journal of Surgical Research
|August 5, 2015
Summary
Thromboelastography (TEG) significantly reduced platelet and cryoprecipitate transfusions in pediatric cardiac surgery. This blood management strategy proved cost-effective without increasing complications.
Area of Science:
- Pediatric Cardiac Surgery
- Transfusion Medicine
- Point-of-Care Testing
Background:
- Blood product administration is frequent in pediatric cardiac surgery.
- The cost-effectiveness of thromboelastography (TEG) for reducing transfusions requires investigation.
Purpose of the Study:
- To evaluate if thromboelastography (TEG) is a cost-effective method for reducing blood product transfusions during pediatric cardiac surgery.
Main Methods:
- A retrospective case-control study compared 50 pediatric cardiac surgery patients who underwent TEG-guided transfusions with 100 control patients.
- Patients were matched for age and risk adjustment for congenital heart surgery score.
- Blood product utilization, transfusion costs, and clinical outcomes were analyzed.
Main Results:
- TEG use led to significant reductions in platelet (1 vs. 2.2 U) and cryoprecipitate (0.7 vs. 1.7 U) transfusions.
- Hospital costs for platelet and cryoprecipitate transfusions decreased by over 50% in the TEG group.
- No significant differences were observed in mortality, length of stay, or postoperative complications.
Conclusions:
- Intraoperative use of TEG effectively reduces platelet and cryoprecipitate transfusions in pediatric cardiac surgery.
- TEG is a cost-effective tool for guiding blood product management, without compromising patient safety.
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