title: Cardiac catheterization: haemostatic changes in pediatric versus adult patients.
abstract: Thrombophilic or haemorrhagic complications are possible adverse events following cardiac catheterization particularly in pediatric patients. It was therefore the aim of our study to compare the cardiac catheterization-related haemostatic changes in children with that in adults. The total of 50 patients was subdivided into Gr I (1-6 years), Gr II (7-18 years), and Gr III (19-58 years). Parameters of coagulation activation, plasma levels of various clotting factors and heparinase-modified thrombelastometry parameters were determined prior and immediately after cardiac catheterization. The haemostatic system of pediatric patients was markedly more affected by the procedure than that of adults. Levels of thrombin/antithrombin complex and prothrombin fragment 1+2 in the post-catheter plasma samples were significantly increased in Grs I and II, not in Gr III. The catheter-related decrease in fibrinogen and F II levels was higher in Gr I than in Grs II and III. F VII levels were significantly decreased in Grs I and II, not in Gr III. The catheter-related prolongation of Coagulation times was highest in Gr I, followed by Gr II and finally Gr III. A significant catheter-related decrease of maximum clot firmness was observed solely in Gr I. Our results show that cardiac catheterisation perturbs the haemostatic system of adults, and, even more pronounced, that of pediatric patients. Thus, our results indicate that children might be at a higher risk for either thrombotic complications or post-operative bleeding events than adults.
authors.affiliation: Institute of Physiological Chemistry, Medical University of Graz, Harrachgasse 21/II, Graz, Austria.
authors.forename: Gerd
authors.initials: G
authors.lastname: Hoerl
authors.forename: Erwin
authors.initials: E
authors.lastname: Tafeit
authors.forename: Bettina
authors.initials: B
authors.lastname: Leschnik
authors.forename: Thomas
authors.initials: T
authors.lastname: Wagner
authors.forename: Wolfgang
authors.initials: W
authors.lastname: Muntean
authors.forename: Guenther
authors.initials: G
authors.lastname: Juergens
authors.forename: Martin
authors.initials: M
authors.lastname: Koestenberger
authors.forename: Gerhard
authors.initials: G
authors.lastname: Cvirn
mesh_terms: D000293:Adolescent; D000328:Adult; D000367:Age Factors; D001777:Blood Coagulation; D001779:Blood Coagulation Factors / Q000032:analysis*; D006328:Cardiac Catheterization / Q000009:adverse effects*; D002648:Child; D002675:Child, Preschool; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007223:Infant; D008297:Male; D008875:Middle Aged; D019106:Postoperative Hemorrhage / Q000097:blood / Q000209:etiology; D012307:Risk Factors; D013916:Thrombelastography / Q000379:methods; D013927:Thrombosis / Q000097:blood / Q000209:etiology
chemical_list: D001779:Blood Coagulation Factors