Document Detail


Thromboelastometry (ROTEM) in children: age-related reference ranges and correlations with standard coagulation tests.
MedLine Citation:
PMID:  20884636     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
BACKGROUND: The small sample volume needed and the prompt availability of results make viscoelastic methods like rotational thromboelastometry (ROTEM) attractive for monitoring coagulation in small children. However, data on reference ranges for ROTEM parameters in children are scarce.
METHODS: Four hundred and seven children (ASA I and II) undergoing elective surgery were recruited for this prospective, two-centre, observational study. Subjects were grouped as follows: 0-3, 4-12, 13-24 months, 2-5, 6-10, and 11-16 yr. Study objectives were to establish age-dependent reference ranges for ROTEM assays, analyse age dependence of parameters, and compare ROTEM data with standard coagulation tests.
RESULTS: Data from 359 subjects remained for final analysis. Except for extrinsically activated clot strength and lysis, parameters for ROTEM assays were significantly different among all age groups. The most striking finding was that subjects aged 0-3 months exhibited accelerated initiation (ExTEM coagulation time: median 48 s, Q1-Q3 38-65 s; P=0.001) and propagation of coagulation (α angle: median 78(o), Q1-Q3 69-84(o); P<0.001) and maximum clot firmness (median 62 mm, Q1-Q3 54-74 mm), although standard plasma coagulation test results were prolonged (prothrombin time: median 13.2 s, Q1-Q3 12.6-13.6 s; activated partial thromboplastin time: median 42 s, Q1-Q3 40-46 s). Lysis indices of <85% were observed in nearly one-third of all children without increased bleeding tendency. Platelet count and fibrinogen levels correlated significantly with clot strength, and fibrinogen levels correlated with fibrin polymerization.
CONCLUSIONS: Reference ranges for ROTEM assays were determined for all paediatric age groups. These values will be helpful when monitoring paediatric patients and in studies of perioperative coagulation in children.
Authors:
E Oswald; B Stalzer; E Heitz; M Weiss; M Schmugge; A Strasak; P Innerhofer; T Haas
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Publication Detail:
Type:  Journal Article; Multicenter Study; Research Support, Non-U.S. Gov't     Date:  2010-09-29
Journal Detail:
Title:  British journal of anaesthesia     Volume:  105     ISSN:  1471-6771     ISO Abbreviation:  Br J Anaesth     Publication Date:  2010 Dec 
Date Detail:
Created Date:  2010-11-18     Completed Date:  2010-12-13     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  0372541     Medline TA:  Br J Anaesth     Country:  England    
Other Details:
Languages:  eng     Pagination:  827-35     Citation Subset:  IM    
Affiliation:
Department of Anaesthesiology and Critical Care Medicine, Innsbruck Medical University, Innsbruck, Austria.
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MeSH Terms
Descriptor/Qualifier:
Adolescent
Aging / blood
Blood Coagulation Tests / methods
Blood Specimen Collection / methods
Child
Child, Preschool
Factor XIII / metabolism
Female
Fibrin / metabolism
Fibrinogen / metabolism
Humans
Infant
Infant, Newborn
Male
Reference Values
Reproducibility of Results
Sex Characteristics
Thrombelastography / methods*
Chemical
Reg. No./Substance:
9001-31-4/Fibrin; 9001-32-5/Fibrinogen; 9013-56-3/Factor XIII

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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