Thromboelastography and Its Use in Pediatric Trauma Patients

Area of Science:

• Pediatric critical care medicine
• Trauma surgery
• Hematology

Background:

• Thromboelastography (TEG) is underutilized in pediatric trauma care.
• Identifying coagulopathies is crucial for guiding transfusion strategies.

Purpose of the Study:

• To investigate the association between TEG parameters and outcomes in pediatric trauma patients.
• To determine if TEG can predict mortality, ICU length of stay, or need for blood product transfusion.

Main Methods:

• Retrospective review of Level 1 pediatric trauma patients.
• Data collected: demographics, diagnoses, Injury Severity Score, ICU LOS, mortality, TEG values, blood products.
• Analysis of TEG values correlated with mortality, ICU LOS, and transfusion requirements.

Main Results:

• Elevated reaction time, K value, and 30-minute fibrinolysis correlated with increased mortality risk.
• Certain TEG parameters (reaction time, K value, 30-minute fibrinolysis, alpha angle, maximum amplitude) were associated with ICU length of stay.
• No significant association found between TEG values and the need for blood product transfusion.

Conclusions:

• Pediatric trauma patients with coagulopathy identified by TEG exhibit higher mortality rates.
• TEG values approaching transfusion cut-off points indicate increased mortality risk.