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A Modified Sonographic Algorithm for Image Acquisition in Life-Threatening Emergencies in the Critically Ill Newborn

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Magnetic Resonance-Based Diagnostics for Bleeding Assessment in Neonatal Cardiac Surgery.

Perry S Choi¹, Sirisha Emani¹, Juan C Ibla²

¹Department of Cardiovascular Surgery, Boston Children's Hospital, Boston, Massachusetts.

The Annals of Thoracic Surgery

|December 31, 2019

Summary

T2 magnetic resonance (T2MR) shows promise in predicting postsurgical bleeding risk in infants after cardiac surgery. This new method accurately identifies infants at risk, improving patient safety.

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Area of Science:

Biomedical Engineering
Pediatric Cardiology
Hematology

Background:

Infants undergoing cardiac surgery face significant bleeding risks.
Current predictive models for postsurgical bleeding in infants are insufficient.

Purpose of the Study:

To evaluate the predictive capability of T2 magnetic resonance (T2MR) for postsurgical bleeding in infants.
To assess T2MR's ability to identify high-risk patients.

Main Methods:

Prospective study of 100 infants (<12 months) undergoing cardiac operations.
T2MR analysis of blood samples to assess clot formation and hemostatic indicators.
Binary recursive partitioning and multivariate modeling with cross-validation.

Main Results:

The tight clot metric showed univariate discrimination of bleeding (AUC 0.64, accuracy 72%).
T2MR's tight clot and platelet function metrics were most important for predicting bleeding.
Multivariate modeling achieved an AUC of 0.74 and 82% classification accuracy.

Conclusions:

T2MR metrics, specifically tight clot and platelet function, are associated with postsurgical bleeding events in infants.
T2MR demonstrates potential as a predictive tool for bleeding risk in this vulnerable population.