Applications of consensus methods in the improvement of care of paediatric patients: a step forward from a ‘good guess’

2013 ◽  
Vol 102 (2) ◽  
pp. 111-115 ◽  
Author(s):  
O Tammela
Keyword(s):  
Consensus Methods ◽  
Paediatric Patients ◽  
Good Guess

Consensus methods in prescribing research

2001 ◽  
Vol 26 (1) ◽  
pp. 5-14 ◽  
Author(s):  
S. M. Campbell ◽  
J. A. Cantrill
Keyword(s):  
Consensus Methods

European paediatric patients with neuromyelitis optica: a good prognosis for most and seronegative to NMO-IgG

2010 ◽  
Vol 41 (02) ◽  
Author(s):  
P Huppke ◽  
M Blüthner ◽  
O Bauer ◽  
W Stark ◽  
K Reinhardt ◽  
...  
Keyword(s):  
Neuromyelitis Optica ◽  
Good Prognosis ◽  
European Paediatric ◽  
Paediatric Patients

Surgical Outcome in Paediatric Patients with Ebstein's Anomaly: A Multicenter, Long-Term Study

2016 ◽  
Vol 64 (S 02) ◽  
Author(s):  
L. Geerdink ◽  
G. du Marchie Sarvaas ◽  
I. Kuipers ◽  
W. Helbing ◽  
T. Delhaas ◽  
...  
Keyword(s):  
Surgical Outcome ◽  
Ebstein’S Anomaly ◽  
Term Study ◽  
Ebstein's Anomaly ◽  
Long Term Study ◽  
Paediatric Patients

Thrombin generation in paediatric patients with congenital heart disease

2008 ◽  
Vol 28 (S 01) ◽  
pp. S61-S66 ◽  
Author(s):  
G. Cvirn ◽  
A. Rosenkranz ◽  
B. Leschnik ◽  
W. Raith ◽  
W. Muntean ◽  
...  
Keyword(s):  
Congenital Heart Disease ◽  
Heart Disease ◽  
Negative Correlation ◽  
Congenital Heart ◽  
Thrombin Generation ◽  
Significant Negative Correlation ◽  
Peak Height ◽  
Global Test ◽  
Paediatric Patients ◽  
Age Range

SummaryThrombin generation was studied in paediatric patients with congenital heart disease (CHD) undergoing cardiac surgery using the calibrated automated thrombography (CAT) in terms of the lag time until the onset of thrombin formation, time to thrombin peak maximum (TTP), endogenous thrombin potential (ETP), and thrombin peak height. The suitability to determine the coagulation status of these patients was investigated. Patients, material, methods: CAT data of 40 patients with CHD (age range from newborn to 18 years) were compared to data using standard coagulation parameters such as prothrombin (FII), antithrombin (AT), tissue factor pathway inhibitor (TFPI), prothrombin fragment 1.2 (F 1.2), thrombin-antithrombin (TAT), activated partial thromboplastin time (aPTT), and prothrombin time (PT). Results: A significant positive correlation was seen between ETP and FII (p < 0.01; r = 0.369), as well as between peak height and F II (p < 0.01; r = 0.483). A significant negative correlation was seen between ETP and TFPI values (p < 0.05; r = –0.225) while no significant correlation was seen between peak height and TFPI. A significant negative correlation was seen between F 1.2 generation and ETP (p < 0.05; r = –0.254) and between F 1.2 generation and peak height (p < 0.05; r = –0.236). No correlation was seen between AT and ETP or peak. Conclusions: CAT is a good global test reflecting procoagulatory and inhibitory factors of the haemostatic system in paediatric patients with CHD.

Coagulation and Fibrinolytic Profile of Paediatric Patients Undergoing Cardiopulmonary Bypass

1997 ◽  
Vol 77 (02) ◽  
pp. 270-277 ◽  
Author(s):  
Anthony K C Chan ◽  
Michael Leaker ◽  
Frederick A Burrows ◽  
William G Williams ◽  
Colleen E Gruenwald ◽  
...  
Keyword(s):  
Cardiopulmonary Bypass ◽  
Plasminogen Activator ◽  
Plasma Concentrations ◽  
Factor Xa ◽  
Plasminogen Activator Inhibitor ◽  
Protein S ◽  
Poor Correlation ◽  
Heparin Cofactor Ii ◽  
Paediatric Patients ◽  
Sick Children

SummaryThe haemostatic system and the use of heparin during cardiopulmonary bypass (CPB) have been studied extensively in adults but not in children. Results from adult trials cannot be extrapolated to children because of age-dependent physiologic differences in haemostasis. We studied 22 consecutive paediatric patients who underwent CPB at The Hospital for Sick Children, Toronto. Fibrinogen, factors II, V, VII, VIII, IX, XI, XII, prekallikrein, protein C, protein S, antithrombin (AT), heparin cofactor II, α2-macroglobulin, plasminogen, α2-antiplas- min, tissue plasminogen activator (tPA), plasminogen activator inhibitor, thrombin-AT complexes (TAT), D-dimer, heparin (by both anti-factor Xa assay and protamine titration) and activated clotting time (ACT) were assayed perioperatively. The timing of the sampling was: pre heparin, post heparin, after initiation of CPB, during hypothermia, post hypothermia, post protamine reversal and 24 h post CPB. Plasma concentrations of all haemostatic proteins decreased by an average of 56% immediately following the initiation of CPB due to haemodilution. During CPB, the majority of procoagulants, inhibitors and some components of the fibrinolytic system (plasminogen, α2AP) remained stable. However, plasma concentrations of TAT and D-dimers increased during CPB showing that significant activation of the coagulation and fibrinolytic systems occurred. Mechanisms responsible for the activation of haemostasis are likely complex. However, low plasma concentrations of heparin (<2.0 units/ml in 45% of patients) during CPB were likely a major contributing etiology. ACT values showed a poor correlation (r = 0.38) with heparin concentrations likely due to concurrent haemodilution of haemostatic factors, activation of haemostatic system, hypothermia and activation of platelets. In conclusion, CPB in paediatric patients causes global decreases of components of the coagulation and fibrinolytic systems, primarily by haemodilution and secondarily by consumption.

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