Combined Use of Rotational Thromboelastometry (Rotem) and Platelet Impedance Aggregometry (Multiplate Analyzer) in Cyanotic and Acyanotic Infants and Children Undergoing Cardiac Surgery With Cardiopulmonary Bypass: Subgroup Analysis of a Randomized Clinical Trial.

Dieu, Audrey;Van Regemorter, Victoria;Detaille, Thierry;Houtekie, Laurent;Momeni, Mona;et.al.
(2021) Journal of Cardiothoracic and Vascular Anesthesia — Vol. 35, n° 7, p. 2115-2123 (2021)

Files

Dieu-2021-Combineduseofrotational.pdf
  • Open Access
  • Adobe PDF
  • 521.32 KB
Download

Details

Authors
  • Dieu, Audreyorcid-logoUCLouvain
    Author
  • Van Regemorter, Victoriaorcid-logoUCLouvain
    Author
  • Detaille, ThierryUCLouvain
    Author
  • Houtekie, LaurentUCLouvain
    Author
  • Khalifa, CélineUCLouvain
    Author
  • Kahn, DavidUCLouvain
    Author
  • Clement De Clety, StéphanUCLouvain
    Author
  • Poncelet, AlainUCLouvain
    Author
  • Momeni, MonaUCLouvain
    Author
Show more
Abstract
OBJECTIVES: Few studies have investigated the Multiplate platelet function analyzer in pediatrics. The authors evaluated Multiplate combined with Rotem in terms of guiding platelet transfusion after pediatric cardiac surgery with cardiopulmonary bypass (CPB). The authors further compared coagulation parameters between cyanotic and acyanotic patients. DESIGN: Subgroup analysis of a randomized clinical trial. SETTING: Tertiary hospital. PARTICIPANTS: Patients weighing between seven and 15 kg. INTERVENTIONS: None. MEASUREMENTS AND MAIN RESULTS: Rotem and Multiplate tests were performed (1) after anesthesia induction, (2) upon CPB separation, and (3) upon intensive care unit arrival. Among a total of 59 subjects, 9 patients required platelet transfusion. In multivariate linear regression, analysis EXTEM maximum clot firmness upon CPB separation was associated with the volume of transfused platelets (regression coefficient = -0.348 [95% confidence interval -1.006 to -0.028]; p = 0.039). No such association was found for the Multiplate test. Acyanotic and cyanotic heart disease were present in 32 and 27 children, respectively. There were no significant differences between these two groups in terms of platelet count and function. Postoperative blood loss was significantly higher in the cyanotic group compared with the acyanotic arm (p = 0.015; difference [95% confidence interval -2.40 {-4.20 to -0.60}]). There were no differences between groups regarding transfusion of allogeneic blood products. CONCLUSIONS: This study showed that Rotem, but not Multiplate results, were associated with platelet transfusion in pediatric cardiac surgery with no intake of platelet inhibitors. The usefulness of combining these tests in platelet transfusion decision-making needs to be evaluated in larger populations.
Affiliations

Citations

  • APA
  • Chicago
  • FWB

Dieu, A., Van Regemorter, V., Detaille, T., Houtekie, L., Eeckhoudt, S., Khalifa, C., Kahn, D., Clement De Clety, S., Poncelet, A., & Momeni, M. (2021). Combined Use of Rotational Thromboelastometry (Rotem) and Platelet Impedance Aggregometry (Multiplate Analyzer) in Cyanotic and Acyanotic Infants and Children Undergoing Cardiac Surgery With Cardiopulmonary Bypass: Subgroup Analysis of a Randomized Clinical Trial. Journal of Cardiothoracic and Vascular Anesthesia, 35(7), 2115-2123. https://doi.org/10.1053/j.jvca.2020.09.133 (Original work published 2021)