Related Experiment Video
Updated: Aug 5, 2026
Leveraging Turbidity and Thromboelastography for Complementary Clot Characterization
Published on: June 4, 2020
A Comparison between Thromboelastography and Conventional Clotting Tests in Pediatric Patients After Cardiopulmonary
Insights
Thromboelastography (TEG) is more sensitive than conventional tests for evaluating coagulation in infants younger than 6 months after cardio-pulmonary bypass surgery. Younger infants showed greater coagulation changes and higher transfusion rates compared to older children.
Area of Science:
- Pediatric Surgery
- Hemostasis and Thrombosis
- Coagulation Diagnostics
Background:
- Infant coagulation systems are immature before 6 months, complicating assessment.
- Pediatricians face challenges selecting appropriate tests for infant surgery.
- This study compares conventional tests with TEG in infants undergoing cardio-pulmonary bypass (CPB).
Purpose of the Study:
- To compare the sensitivity of conventional coagulation tests and TEG.
- To evaluate coagulation function in infants undergoing CPB surgery.
- To identify differences in coagulation response between younger (<6 months) and older infants.
Main Methods:
- Compared PT, APTT, TT, and Fibrinogen with TEG parameters (R-time, ɑ-Angle, K-time, MA).
- Analyzed pre- and post-CPB values and their rates of change.
- Compared outcomes between infants <6 months (n=72) and 6 months to 12 years (n=76).
Main Results:
- Both groups showed increased PT, APTT, R-time, K-time and decreased Fib, ɑ-Angle, MA post-CPB.
- Younger infants had significantly higher rates of R-time/K-time increase and ɑ-Angle/MA decrease post-CPB (p < 0.01).
- Younger infants required significantly more postoperative transfusions of red cells, plasma, and cryoprecipitate.
Conclusions:
- Thromboelastography (TEG) is more sensitive than conventional tests for detecting coagulation changes in young infants post-surgery.
- Conventional coagulation tests showed no significant differences between age groups post-CPB.
- TEG provides a more comprehensive assessment of coagulation dynamics in pediatric CPB patients.
Background:
The coagulation system is more complicated in younger infants because the hemostatic system is not completely mature before 6 months. There is confusion among pediatricians to choose conventional coagulation tests and thromboelastography (TEG) to evaluate coagulation function for infants in major surgery. This study was undertaken to perform a comparison between the two methods for pediatric patients who underwent cardio-pulmonary bypass (CPB) surgery.
Methods:
Infant patients who underwent CPB surgery were divided into two groups - younger group (age < 6 months old, n = 72) and older group (age from 6 months old to 12 years old, n = 76). Prothrombin time (PT), activated partial thromboplastin time (APTT), thrombin time (TT), and fibrinogen (Fib) of conventional coagulation tests and reaction time (R-time), speed of fibrin building up (ɑ-Angle), clot conformation time (K-time), maximum colt amplitude (MA) of TEG results before and after CPB, as well as increasing or decreasing rate of all the values after CPB, were compared between the two groups. Postoperative transfusion details were summarized.
Results:
PT, APTT, R-time, and K-time markedly increased (p < 0.05) and Fib, ɑ-Angle, and MA decreased (p < 0.05) after CPB in both groups. The younger group had a much higher rate of postoperative transfusion with suspended red cells (54.17% vs. 17.11%), fresh frozen plasma (29.17% vs. 9.21%), cryoprecipitate (9.72% vs. 1.32%), and apheresis platelet (5.56% vs. 0) than the older group. Increasing rate of R-time and K-time and decreasing rate of ɑ-Angle and MA after CPB in the younger group were significantly higher than that in the older group (p < 0.01), whereas no significant differences were observed in conventional coagulation tests (p > 0.2).
Conclusions:
TEG was more sensitive than conventional coagulation tests in response to variation of coagulation function for younger infants after major surgery.
Related Concept Videos
01:17Imaging Studies for Cardiovascular System I:Echocardiography
Indications: Echocardiography is utilized to diagnose heart failure, valve disorders, and myocardial infarction. It also assesses cardiac structures' size, shape, and motion, evaluates...
01:20Imaging Studies for Cardiovascular System II:Types of Echocardiography
Types of Echocardiography
Transthoracic Echocardiography (TTE)
TTE is the most common type of echocardiogram which involves placing a transducer on the patient's chest, emitting sound waves to create heart images. TTE is invaluable for evaluating the heart's size, structure, and motion, making it particularly useful for diagnosing...
01:20Imaging Studies for Cardiovascular System III: X-Ray
Definition and Purpose
An X-ray, or radiograph, is a non-invasive method that uses ionizing radiation to take images of internal structures. It is mainly used in cardiac imaging to examine the heart, lungs, and major blood vessels, aiming to identify abnormalities in the heart's size, shape, and position, such as heart failure, congenital defects, and vascular...
01:28Imaging Studies for Cardiovascular System V: CT
01:23Mitral Stenosis II: Clinical features and Diagnostic Tests
01:30Dysrhythmias V: Evaluating Dysrhythmias