Related Experiment Video
Updated: Feb 7, 2026
05:42
Z-Scores for Assessing Ovarian Reserve in Young Patients Undergoing Fertility Preservation
Published on: October 25, 2024
1.6K
Thromboelastometry as an Alternative Method for Coagulation Assessment in Pediatric Patients Undergoing Invasive
Miroslav Durila1, Jakub Jonas1, Marianna Durilova2
1Department of Anesthesiology and Intensive Care Medicine, Motol University Hospital, Second Faculty of Medicine, Charles University, Prague, Czech Republic.
Summary
In pediatric patients, normal rotational thromboelastometry (ROTEM) results despite prolonged standard coagulation tests (activated partial thromboplastin time [aPTT] and prothrombin time [PT]) were not associated with severe bleeding during invasive procedures.
Area of Science:
- Pediatric critical care medicine
- Hemostasis and thrombosis
- Point-of-care diagnostics
Background:
- Standard coagulation tests (aPTT, PT) assess coagulation but don't reflect whole blood dynamics.
- Rotational thromboelastometry (ROTEM) is a point-of-care viscoelastic test evaluating whole blood coagulation.
- Discrepancies between ROTEM and standard tests may occur in critically ill children.
Purpose of the Study:
- To investigate severe bleeding risk in pediatric patients with normal ROTEM but prolonged aPTT/PT.
- To evaluate ROTEM as a reliable alternative for coagulation assessment in pediatric invasive procedures.
Main Methods:
- Retrospective analysis of pediatric patient data (2015-2017).
- Included patients with prolonged aPTT or PT and normal ROTEM (INTEM and EXTEM).
- Assessed for severe bleeding during or after invasive procedures.
Main Results:
- 26 pediatric patients (2 months-17 years) had normal INTEM/EXTEM with prolonged aPTT/PT ratios.
- Median aPTT ratio was 1.47, INR 1.4, and PT ratio 1.30.
- No severe bleeding events were observed during or after invasive procedures.
Conclusions:
- ROTEM can be a reliable alternative coagulation test in pediatric patients undergoing invasive procedures.
- Normal ROTEM with prolonged PT/aPTT suggests no increased bleeding risk.
- ROTEM may reduce fresh frozen plasma administration and expedite patient preparation.
Related Concept Videos
01:26Pharmacokinetics in Pediatric Patients: Drug Excretion
266
In pediatric medicine, understanding the renal function and drug elimination nuances is crucial for administering safe and effective treatments. Newborns, in particular, display markedly slower renal functions than adults, profoundly affecting how drugs are cleared from their bodies. This slower drug clearance requires clinicians to extend the dosing intervals for many medications to prevent drug accumulation and toxicity while ensuring therapeutic efficacy.One key area where these adjustments...
266
01:17Pharmacokinetics in Pediatric Patients: Drug Distribution
314
Drug distribution in the pediatric population exhibits unique challenges and considerations due to the physiological differences between children, particularly neonates and infants, and adults. A crucial aspect of pediatric pharmacology is understanding how these differences impact the pharmacokinetics of various drugs, necessitating age-specific dosing strategies to ensure efficacy and safety.Neonates and infants have a higher total body water content, ~75%–90% of their body weight,...
314
01:24Pharmacokinetics in Pediatric Patients: Drug Metabolism
237
In pediatric care, understanding the nuances of hepatic drug metabolism is crucial, as it significantly differs from that of adults. This divergence is primarily due to the developmental stage of drug-metabolizing enzymes, which affects how medications are processed in the body. In neonates, for instance, the activity of Phase I enzymes—critical for the initial breakdown of drugs—is markedly reduced, functioning at just 20–40% of the levels seen in adults. This reduction poses...
237
01:06Coagulation
1.4K
Colloidal solids are solid particles suspended in solution. They are usually negatively charged, attracting a compact primary layer of positively charged ions, which attract more counterions to form an electrical double layer. Electrostatic repulsion between the charged double layers prevents the particles from colliding, stabilizing the colloids. These solids are often undesirable because they can contain toxins that are difficult to remove. Coagulation is a technique that helps aggregate and...
1.4K
01:09Coagulation
10.6K
The coagulation phase is a critical part of the body's process to prevent blood loss following injury to blood vessels. It involves chemical reactions that form a clot to seal the injured area. The clotting process begins shortly after injury, within 15-20 seconds for severe damage and 1-2 minutes for minor injuries.
During the coagulation phase, clotting factors, or procoagulants, play a vital role in initiating and progressing the coagulation cascade. This cascade is a series of reactions...
During the coagulation phase, clotting factors, or procoagulants, play a vital role in initiating and progressing the coagulation cascade. This cascade is a series of reactions...
10.6K
01:23Pharmacokinetics in Pediatric Patients: Overview and Drug Absorption
305
Understanding the physiological differences in the pediatric population is crucial for effective pharmacotherapy. Neonates, infants, and children exhibit significant variations in gastric pH, gastric emptying time, intestinal transit time, and biliary function. These variations profoundly affect oral drug absorption, necessitating a nuanced approach to pediatric dosing.Neonates present with a unique physiological profile, having a gastric pH greater than 4 and faster and more irregular gastric...
305