Calibrated automated thrombogram values in infants with cardiac surgery before and after cardiopulmonary bypass

摘要

Abstract Introduction Impaired thrombin generation has been associated to increase bleeding after cardiac surgery with cardiopulmonary bypass (CPB), especially in children. The aim of this study was to evaluate standard coagulation assay, thrombin generation by calibrated automated thrombogram (CAT), thromboelastography (TEG) and procoagulant phospholipids (PPL) activity in infants undergoing cardiac surgery with CPB. Materials and methods Prospective observational study performed in children aged Results Forty-nine children aged Conclusions Thrombin generation is significantly impaired in children affected by congenital heart disease, compared to healthy children and adults. CAT parameters resulted age-dependent, and thrombin generation is lower in infants aged Highlights ? Coagulation was evaluated by calibrated automated thrombogram and thromboelastography in children (aged ? Baseline thrombin generation is lower in infants aged ? Twelve hours after cardiac surgery with cardiopulmonary bypass a coagulopathy documented only by CAT and TEG, was found, despite transfusions of blood products. ? For the first time in children procoagulant phospholipids (PPL) were evaluated after cardiac operation and PPL clotting times resulted longer than baseline values (indicating inadequate coagulation as CAT and TEG).