دورية أكاديمية
Comparison of Thromboelastography Devices TEG ® 6S Point of Care Device vs. TEG ® 5000 in Pediatric Patients Undergoing Cardiac Surgery.
| العنوان: | Comparison of Thromboelastography Devices TEG ® 6S Point of Care Device vs. TEG ® 5000 in Pediatric Patients Undergoing Cardiac Surgery. |
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| المؤلفون: | Emani S; Department of Cardiac Surgery, Boston Children's Hospital, Boston, Massachusetts., Emani VS; MIT-PRIMES Program, Massachusetts Institute of Technology, Cambridge, Massachusetts; and., Diallo FB; Department of Cardiac Surgery, Boston Children's Hospital, Boston, Massachusetts., Dutta P; Department of Cardiac Surgery, Boston Children's Hospital, Boston, Massachusetts., Matte GS; Department of Cardiac Surgery, Boston Children's Hospital, Boston, Massachusetts., Nathan M; Department of Cardiac Surgery, Boston Children's Hospital, Boston, Massachusetts., Ibla JC; Division of Cardiac Anesthesia, Department of Anesthesiology, Critical Care, and Pain Medicine, Boston Children's Hospital, Boston, Massachusetts., Emani SM; Department of Cardiac Surgery, Boston Children's Hospital, Boston, Massachusetts. |
| المصدر: | The journal of extra-corporeal technology [J Extra Corpor Technol] 2022 Mar; Vol. 54 (1), pp. 42-49. |
| نوع المنشور: | Journal Article |
| اللغة: | English |
| بيانات الدورية: | Publisher: EDP Sciences Country of Publication: United States NLM ID: 0267637 Publication Model: Print Cited Medium: Print ISSN: 0022-1058 (Print) Linking ISSN: 00221058 NLM ISO Abbreviation: J Extra Corpor Technol |
| أسماء مطبوعة: | Publication: 2023- : [Les Ulis Cedex, France] : EDP Sciences Original Publication: St. Paul, Minn., American Society of Extra-Corporeal Technology. |
| مواضيع طبية MeSH: | Thrombelastography*/methods , Cardiac Surgical Procedures*/adverse effects, Humans ; Child ; Point-of-Care Systems ; Retrospective Studies ; Fibrinogen/therapeutic use ; Fibrinogen/analysis |
| مستخلص: | Thromboelastography (TEG) can predict bleeding in pediatric patients undergoing cardiac surgery. We hypothesized that results obtained from TEG ® 5000 correlate with the new point-of-care TEG ® 6S system and that TEG ® 6S rewarming maximum amplitude (MA) is associated with surrogate endpoints for perioperative bleeding in pediatric patients who underwent complex cardiac surgery. We describe a retrospective study of pediatric (≤18 years) patients who underwent complex cardiac surgery on cardiopulmonary bypass. Citrate whole-blood samples were used to compared TEG ® 5000 vs.TEG ® 6S and TEG ® 6S-FLEV (with fibrinogen measurement) vs. Clauss-fibrinogen methods. TEG ® 6S parameters obtained during rewarming were compared to the surrogate endpoints for perioperative bleeding using linear regression analysis. Among 100 patients, 225 TEG ® 5000 vs.TEG ® 6S comparisons and 54 TEG ® 6S-FLEV were analyzed. Good correlation was observed for all parameters comparing TEG ® 5000 to TEG ® 6S and TEG ® 6S-FLEV to the Clauss-fibrinogen method (Pearson r ≥ .7). Similar to rewarming TEG ® 5000 MA, rewarming TEG ® 6S MA was the only parameter independently associated with risk for perioperative bleeding (median [interquartile range {IQR}] in bleeding vs. nonbleeding patients: 35 [29, 48] vs. 37 [32, 55]; p = .02). A platelet transfusion calculator was developed based on TEG ® 6S results by determining the relationship between platelet transfusion volume (mL/kg) and percent change in MA using linear regression analysis. TEG ® 6S is a good alternative point-of-care method to analyze a patient's coagulation profile and it is comparable to TEG ® 5000 in pediatric patients undergoing cardiac surgery on cardiopulmonary bypass. Lower TEG ® 6S MA during rewarming is associated with increased risk for perioperative bleeding. TEG analysis during rewarming may be useful in customizing platelet transfusion therapy by reducing the risk of bleeding while minimizing excessive blood product transfusions. (© Copyright 2022 AMSECT.) |
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| فهرسة مساهمة: | Keywords: anti-coagulation; congenital heart disease.; fibrinogen; pediatric cardiac surgery; thromboelastography (TEG) |
| المشرفين على المادة: | 9001-32-5 (Fibrinogen) |
| تواريخ الأحداث: | Date Created: 20221116 Date Completed: 20221118 Latest Revision: 20221118 |
| رمز التحديث: | 20221213 |
| مُعرف محوري في PubMed: | PMC9639686 |
| DOI: | 10.1182/ject-42-49 |
| PMID: | 36380826 |
| قاعدة البيانات: | MEDLINE |
| تدمد: | 0022-1058 |
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| DOI: | 10.1182/ject-42-49 |