Abstract
Background and aim: Many of inflammation mediators are involved in the coagulation proteins activation. Then aim of study was evaluated useful of thromboelastography for coagulation disorders diagnosis in critically ill patients.
Methods: By a serial cases design, we realized during three months a study with patients in critical state during stay in a pediatric intensive care unit. Every patient blood sample (1 ml) was obtained by venous peripheral puncture, carrying out analysis with a digital thromboelastograph, using for processing two types of reagent; unique (kaolin) or cocktail (kaolin+heparinase). Dynamics of clot was analyzed by seven indicators and for comparison we established groups for gender, pathology, infection and type attention condition. Data analysis was by non parametric statistics.
Results: We included 53 samples of a similar number of patients. Most frequent boss of coagulation disorder was hypocoagulation state (31/58.94%). Sensibility test was 82% with 76% specificity. Time for achieve force of clot showed difference (p=0.049) between patients with or without infection, as well as, in alpha angle (p=0.039), maximum clot extend (p=0.40), global clot (p=0.025) and in index of coagulation (p=0.036) in agreement to the type of reagent. Difference not exist (p>0.05) between boys and girls, or by surgical and clinical conditions.
Conclusions: Thromboelastography is a useful tool for coagulation disorders diagnosis in critically ill patients. We suggest and promote his rationale use in more pediatric disorders and conditions. This avoid unnecessary transfusions and reduce cost of hospitable stay.
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Herrera, J., Treviño, A. & Hernández, R. 834 Useful Evaluation of Thromboelastography for Coagulation Disorders in Critically Ill Patients. Pediatr Res 68 (Suppl 1), 419 (2010). https://doi.org/10.1203/00006450-201011001-00834
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DOI: https://doi.org/10.1203/00006450-201011001-00834
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