HEPTEM α significantly decreased after two interventions and significantly increased after two interventions. HEPTEM MCF significantly increased after 3/4 interventions. HFC administration after CPB termination significantly improved FIBTEM MCF by 2.6 mm (p < 0.001). PLT administration during CPB improved HEPTEM α by 22.1° ( p < 0.001) and FIBTEM maximum clot firmness (MCF) by 2.9 mm (p < 0.001). Regression models suggested significant changes in HEPTEM clotting time after all interventions.
Resultsĭata from 161 patients were analyzed. ROTEM assays were also performed in the post-CPB period after further blood component therapy administration. ROTEM assays were performed prior to surgery commencement, on CPB prior to platelet administration and following 38 mL/kg platelets, and post-CPB after protamine and HFC administration. MethodsĮach surgery had at least four interventions: initiating CPB platelet administration during rewarming phase post-CPB and following protamine and human fibrinogen concentrate (HFC) administration and further component therapy if bleeding persisted and ROTEM indicated a deficiency. We quantified ROTEM value changes in pediatric patients on cardiopulmonary bypass (CPB) before, during and after blood product transfusion. However, similar evidence in newborns, neonates, and young infants is lacking.
Rotational thromboelastometry (ROTEM) has been shown to reduce the need for transfused blood products in adult and pediatric cardiac surgery patients.
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