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Reference Intervals of Thromboelastometric Evaluation of Coagulation in Pediatric Patients with Congenital Heart Diseases: A Retrospective Investigation

 Ji Young Kim  ;  Yu Rim Shin  ;  Hae Keum Kil  ;  Mi Ran Park  ;  Jong Wha Lee 
 MEDICAL SCIENCE MONITOR, Vol.22 : 3576-3587, 2016 
Journal Title
Issue Date
Adolescent ; Blood Coagulation/physiology ; Blood Coagulation Tests/methods ; Child ; Child, Preschool ; Female ; Heart Defects, Congenital/blood* ; Humans ; Infant ; Infant, Newborn ; Male ; Reference Values ; Retrospective Studies ; Thrombelastography/methods* ; Thrombelastography/standards
BACKGROUND Rotational thromboelastometry (ROTEM®) is a point-of-care test for coagulation, enabling physicians to make a swift decision. The aim of this investigation was to establish reference intervals of thromboelastometric evaluation for coagulation in pediatric patients with congenital heart diseases (CHD). MATERIAL AND METHODS As baseline data, 3 assays of ROTEM® (INTEM, EXTEM, and FIBTEM) were measured after anesthesia induction. ROTEM® parameters were clotting time (CT), amplitude at 10 min (A10), clot formation time (CFT), a angle, maximal clot firmness (MCF), clot lysis index at 60 min (LI60), and maximal clot elasticity (MCE). As age is a well-known factor for maturation, age groups were determined as follows; 1) <1 month, 2) 1-3 months, 3) 4-12 months, 4) 1-3 years, 5) 4-6 years, 6) 7-12 years, and 7) 13-16 years. Reference limits representing 95% of distribution of ROTEM® parameters and 90% confidence intervals of upper and lower reference limits were calculated. RESULTS The data of 413 patients were analyzed. Although INTEM CT was prolonged, significantly shorter CT and CFT, steeper α, and greater A10, MCF, and MCE were shown in patients age <3 months compared to older children. CONCLUSIONS Reference intervals of thromboelastometric evaluation for coagulation from pediatric patients with CHD were shown to have similar pattern to those obtained from healthy pediatric patients. Pediatric patients with CHD, even with cyanosis, were demonstrated to have functionally intact coagulation profile before surgery.
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1. College of Medicine (의과대학) > Dept. of Anesthesiology and Pain Medicine (마취통증의학교실) > 1. Journal Papers
1. College of Medicine (의과대학) > Dept. of Thoracic and Cardiovascular Surgery (흉부외과학교실) > 1. Journal Papers
Yonsei Authors
Kil, Hae Keum(길혜금)
Kim, Ji Young(김지영) ORCID logo https://orcid.org/0000-0001-5822-0338
Shin, Yu Rim(신유림)
Lee, Jong Wha(이종화)
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