title: Activated thrombelastogram in neonates and infants with complex congenital heart disease in comparison with healthy children.
abstract: BACKGROUND
  The goal of the study was to determine activated thrombelastographic (TEG(R)) parameters with the rotational TEG(R) (ROTEG or ROTEM) device (Pentapharm GmbH, Munich, Germany) in neonates and infants <1 yr with complex congenital heart disease (CCHD) and to compare them with those of healthy children.
  
  
  METHODS
  A total of 59 children were included: Group I (Gr I) 24 children, ASA I, scheduled for minor surgery; and Group II (Gr II) 35 children with CCHD, ASA III-IV, scheduled for cardiac surgery. Each group was subdivided into four age groups. Blood samples were obtained before the surgical procedure.
  
  
  RESULTS
  Statistically significant differences (two-way anova analysis) between Gr I and Gr II [mean (SD); P-value] were found in INTEG-CT [Gr I 175(19), Gr II 271(162); P=0.049], EXTEG-MCF [Gr I 63(8), Gr II 56(8); P=0.013], EXTEG-MCE [Gr I 186(65), Gr II 137(41); P=0.003], FIBTEG-MCF [Gr I 24(7), Gr II 19(5); P=0.012], FIBTEG-MCE [Gr I 32(13), Gr II 24(8); P=0.012] and EXTEG-MCE-FIBTEG-MCE [Gr I 155(55), Gr II 113(37); P=0.003]. Clotting time via contact activation was prolonged in Gr II and varied widely, mainly in the age group 0-1 month and to a lesser extent in 1-3 months, and maximum clot firmness was reduced in the same age groups. In comparison with Gr II, the healthy children showed relatively homogenous TEG values with a tendency to hypercoagulability; the maximum was found in age group 1-3 months, decreasing towards adult values in the course of the first year of life.
  
  
  CONCLUSIONS
  These preliminary TEG results indicate that the coagulation-fibrinolytic system in CCHD patients <1 yr is functionally intact and balanced but at a lower level than in healthy children. This could be interpreted as a reduction in the haemostatic potential with less reserve.
authors.affiliation: Department of Anaesthesiology and Intensive Care, General Hospital Linz, Austria. bettina.haizinger@akh.linz.at
authors.forename: B
authors.initials: B
authors.lastname: Haizinger
authors.forename: H
authors.initials: H
authors.lastname: Gombotz
authors.forename: P
authors.initials: P
authors.lastname: Rehak
authors.forename: G
authors.initials: G
authors.lastname: Geiselseder
authors.forename: R
authors.initials: R
authors.lastname: Mair
mesh_terms: D000375:Aging / Q000097:blood; D001777:Blood Coagulation; D005260:Female; D005342:Fibrinolysis; D006330:Heart Defects, Congenital / Q000097:blood* / Q000601:surgery; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D008297:Male; D011300:Preoperative Care / Q000379:methods; D011446:Prospective Studies; D013916:Thrombelastography