Earlier detection of coagulopathy with thromboelastometry during pediatric cardiac surgery: a prospective observational study

2013 ◽  
Vol 23 (3) ◽  
pp. 222-227 ◽  
Author(s):  
Birgitta S. Romlin ◽  
Håkan Wåhlander ◽  
Mats Synnergren ◽  
Fariba Baghaei ◽  
Anders Jeppsson
Keyword(s):  
Cardiac Surgery ◽  
Observational Study ◽  
Prospective Observational Study ◽  
Pediatric Cardiac Surgery

scholarly journals Prevention of postoperative bleeding after complex pediatric cardiac surgery by early administration of fibrinogen, prothrombin complex and platelets: a prospective observational study

2020 ◽  
Vol 20 (1) ◽  
Author(s):  
Nils Dennhardt ◽  
Robert Sümpelmann ◽  
Alexander Horke ◽  
Oliver Keil ◽  
Katja Nickel ◽  
...  
Keyword(s):  
Cardiac Surgery ◽  
Observational Study ◽  
Blood Volume ◽  
Prospective Observational Study ◽  
Postoperative Bleeding ◽  
Maximum Amplitude ◽  
Mean Value ◽  
Pediatric Cardiac Surgery ◽  
Early Administration ◽  
Coagulation Parameters

Abstract Background Postoperative bleeding is a major problem in children undergoing complex pediatric cardiac surgery. The primary aim of this prospective observational study was to evaluate the effect of an institutional approach consisting of early preventive fibrinogen, prothrombin complex and platelets administration on coagulation parameters and postoperative bleeding in children. The secondary aim was to study the rate of re-intervention and postoperative transfusion, the occurrence of thrombosis, length of mechanical ventilation, ICU stay and mortality. Methods In fifty children (age 0–6 years) with one or more predefined risk factors for bleeding after cardiopulmonary bypass (CPB), thrombelastography (TEG) and standard coagulation parameters were measured at baseline (T1), after CPB and reversal of heparin (T2), at sternal closure (T3) and after 12 h in the ICU (T4). Clinical bleeding was evaluated by the surgeon at T2 and T3 using a numeric rating scale (NRS, 0–10). Results After CPB and early administration of fibrinogen, prothrombin complex and platelets, the clinical bleeding evaluation score decreased from a mean value of 6.2 ± 1.9 (NRS) at T2 to a mean value of 2.1 ± 0.8 at T3 (NRS; P <  0.001). Reaction time (R), kinetic time (K), maximum amplitude (MA) and maximum amplitude of fibrinogen (MA-fib) improved significantly (P <  0.001 for all), and MA-fib correlated significantly with the clinical bleeding evaluation (r = 0.70, P <  0.001). The administered total amount of fibrinogen (mg kg− 1) correlated significantly with weight (r = − 0.42, P = 0.002), priming volume as percentage of estimated blood volume (r = 0.30, P = 0.034), minimum CPB temperature (r = − 0.30, P = 0.033) and the change in clinical bleeding evaluation from T2 to T3 (r = 0.71, P <  0.001). The incidence of postoperative bleeding (> 10% of estimated blood volume) was 8%. No child required a surgical re-intervention, and no cases of thrombosis were observed. Hospital mortality was 0%. Conclusion In this observational study of children with an increased risk of bleeding after CPB, an early preventive therapy with fibrinogen, prothrombin complex and platelets guided by clinical bleeding evaluation and TEG reduced bleeding and improved TEG and standard coagulation parameters significantly, with no occurrence of thrombosis or need for re-operation. Trial registration German Clinical Trials Register DRKS00018109 (retrospectively registered 27th August 2019).

Predictors of Early Extubation After Pediatric Cardiac Surgery: A Single-Center Prospective Observational Study

2016 ◽  
Vol 37 (7) ◽  
pp. 1241-1249 ◽  
Author(s):  
Çağlar Ödek ◽  
Tanıl Kendirli ◽  
Tayfun Uçar ◽  
Ayhan Yaman ◽  
Ercan Tutar ◽  
...  
Keyword(s):  
Cardiac Surgery ◽  
Observational Study ◽  
Prospective Observational Study ◽  
Pediatric Cardiac Surgery ◽  
Early Extubation ◽  
Single Center

Prospective Incidence Study of Bloodstream Infection in Infants and Children With Central Venous Catheters After Cardiac Surgery in Italy

2009 ◽  
Vol 30 (7) ◽  
pp. 698-701 ◽  
Author(s):  
Stefania Bezzio ◽  
C. Scolfaro ◽  
R. Broglia ◽  
R. Calabrese ◽  
F. Mignone ◽  
...  
Keyword(s):  
Risk Factors ◽  
Cardiac Surgery ◽  
Observational Study ◽  
Bloodstream Infection ◽  
Medical Staff ◽  
Prospective Observational Study ◽  
Central Venous Catheters ◽  
Central Venous ◽  
In Infants And Children ◽  
Catheter Related Bloodstream Infection

This prospective observational study was designed to assess the incidence of, risk factors for, and outcome of catheter-related bloodstream infection in children undergoing cardiac surgery. A staff specifically trained to handle the central venous catheters with proper aseptic techniques and an appropriate patient to medical staff ratio remain the most effective measures to prevent this infection.

Continuous Monitoring of Lactate Using Intravascular Microdialysis in High-Risk Cardiac Surgery: A Prospective Observational Study

2017 ◽  
Vol 31 (1) ◽  
pp. 37-44 ◽  
Author(s):  
Pavel I. Lenkin ◽  
Alexey A. Smetkin ◽  
Ayyaz Hussain ◽  
Andrey I. Lenkin ◽  
Konstantin V. Paromov ◽  
...  
Keyword(s):  
Cardiac Surgery ◽  
High Risk ◽  
Observational Study ◽  
Continuous Monitoring ◽  
Prospective Observational Study
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