Reference values for kaolin-activated thromboelastography in healthy children.
BACKGROUND
The hemostatic system of children changes with age and differs significantly from the hemostatic system of adults. Age-specific reference values are therefore required for most hemostatic variables. Thromboelastography (TEG) is a point-of-care coagulation test that may provide superior evaluation and management of coagulopathies after cardiac surgery, when large-dose unfractionated heparin is administered for cardiopulmonary bypass. In this study, we established reference values for kaolin-activated TEG in healthy children, to facilitate accurate interpretation of pediatric TEG results.


METHODS
Kaolin-activated TEG was performed on 100 healthy children undergoing elective day surgery and 25 healthy adult volunteers. The following TEG variables were recorded: reaction time, coagulation time, alpha angle, maximum amplitude, percentage lysis 30 min after maximum amplitude was reached, and the coagulation index. Differences between age-groups were evaluated using analysis of variance.


RESULTS
Age-specific reference values for kaolin-activated TEG in healthy children between 1 mo and 16 yr of age are presented. No significant differences between children and adults were observed.


CONCLUSIONS
TEG results, from a particular clinical setting, must be compared to age-specific, as well as analyzer- and activator-specific, reference values to allow for correct interpretation of the results. Reference values provided here will be of use in acute clinical situations where a practical monitor of hemostasis is required.
Department of Clinical Hematology, Royal Children's Hospital, Melbourne, Australia.
Kah-Lok
KL
Chan
Robyn G
RG
Summerhayes
Vera
V
Ignjatovic
Stephen B
SB
Horton
Paul T
PT
Monagle
D000293:Adolescent; D000328:Adult; D001777:Blood Coagulation / Q000502:physiology; D001780:Blood Coagulation Tests / Q000379:methods / Q000592:standards; D002648:Child; D002675:Child, Preschool; D006801:Humans; D007223:Infant; D007616:Kaolin / Q000494:pharmacology*; D008875:Middle Aged; D012016:Reference Values; D013916:Thrombelastography / Q000187:drug effects* / Q000379:methods / Q000592:standards*
D007616:Kaolin