Treatment and monitoring of coagulation abnormalities in children undergoing heart surgery

Paediatric Anaesthesia

Volumn 21, Issue 5, 2011, Pages 494-503

  Arnold, Philip ^a  

^a ALDER HEY CHILDREN S HOSPITAL   (United Kingdom)

Author keywords

antifibrinolytic drugs; blood transfusion; cardiac surgery; coagulation; congenital heart disease; hematology; massive transfusions; thromboelastogram

Indexed keywords

AMINOCAPROIC ACID; APROTININ; BLOOD CLOTTING FACTOR 13 CONCENTRATE; DESMOPRESSIN; FIBRINOGEN; FRESH FROZEN PLASMA; HEPARIN LYASE; KAOLIN; RECOMBINANT BLOOD CLOTTING FACTOR 7A; TRANEXAMIC ACID;

BLOOD; BLOOD CLOTTING DISORDER; BLOOD CLOTTING TEST; EXTRACORPOREAL CIRCULATION; HEART SURGERY; HUMAN; POINT OF CARE TESTING; POSTOPERATIVE HEMORRHAGE; PRIORITY JOURNAL; REVIEW; THROMBOCYTE DYSFUNCTION; THROMBOCYTE TRANSFUSION; THROMBOCYTOPENIA; THROMBOELASTOGRAPHY;

BIOLOGICAL PRODUCTS; BLOOD COAGULATION DISORDERS; BLOOD COAGULATION TESTS; CARDIAC SURGICAL PROCEDURES; CARDIOPULMONARY BYPASS; CHILD; CHILD, PRESCHOOL; HUMANS; INFANT; INFANT, NEWBORN; MONITORING, INTRAOPERATIVE; POINT-OF-CARE SYSTEMS;

EID: 79954547967     PISSN: 11555645     EISSN: 14609592     Source Type: Journal    
DOI: 10.1111/j.1460-9592.2010.03461.x     Document Type: Review

References (84)

1. Szekely A, Cserep Z, Sapi E, et al. Risks and predictors of blood transfusion in pediatric patients undergoing open heart operations. Ann Thorac Surg 2009; 87 (1): 187-197.
2. Williams GD, Bratton SL, Ramamoorthy C,. Factors associated with blood loss and blood product transfusions: a multivariate analysis in children after open-heart surgery. Anesth Analg 1999; 89 (1): 57-64. (Pubitemid 29293309)
3. Miller BE, Mochizuki T, Levy JH, et al. Predicting and treating coagulopathies after cardiopulmonary bypass in children. Anesth Analg 1997; 85 (6): 1196-1202. (Pubitemid 28130510)
4. Hoffman M,. A cell-based model of coagulation and the role of factor VIIa. Blood Rev 2003; 17 (Suppl 1): S1-S5. (Pubitemid 37362777)
5. Tripodi A, Chantarangkul V, Mannucci PM,. Acquired coagulation disorders: revisited using global coagulation/anticoagulation testing. Br J Haematol 2009; 147 (1): 77-82.
6. Velik-Salchner C, Haas T, Innerhofer P, et al. The effect of fibrinogen concentrate on thrombocytopenia. J Thromb Haemost 2007; 5 (5): 1019-1025. (Pubitemid 46691732)
7. Paparella D, Brister SJ, Buchanan MR,. Coagulation disorders of cardiopulmonary bypass: a review. Intensive Care Med 2004; 30 (10): 1873-1881. (Pubitemid 39468407)
8. Burman JF, Chung HI, Lane DA, et al. Role of factor XII in thrombin generation and fibrinolysis during cardiopulmonary bypass. Lancet 1994; 8931: 1192-1193. (Pubitemid 24323709)
9. Williams GD, Bratton SL, Nielsen NJ, et al. Fibrinolysis in pediatric patients undergoing cardiopulmonary bypass. J Cardiothorac Vasc Anesth 1998; 12 (6): 633-638. (Pubitemid 29001678)
10. Chung JH, Gikakis N, Rao AK, et al. Pericardial blood activates the extrinsic coagulation pathway during clinical cardiopulmonary bypass. Circulation 1996; 93 (11): 2014-2018. (Pubitemid 26165564)
11. Kern FH, Morana NJ, Sears JJ, et al. Coagulation defects in neonates during cardiopulmonary bypass. Ann Thorac Surg 1992; 54 (3): 541-546.
12. Chan AK, Leaker M, Burrows FA, et al. Coagulation and fibrinolytic profile of paediatric patients undergoing cardiopulmonary bypass. Thromb Haemost 1997; 77 (2): 270-277. (Pubitemid 27084914)
13. Osthaus WA, Boethig D, Johanning K, et al. Whole blood coagulation measured by modified thrombelastography (ROTEM) is impaired in infants with congenital heart diseases. Blood Coagul Fibrinolysis 2008; 19 (3): 220-225. (Pubitemid 351498726)
14. Tempe DK, Virmani S,. Coagulation abnormalities in patients with cyanotic congenital heart disease. J Cardiothorac Vasc Anesth 2002; 16 (6): 752-765. (Pubitemid 36076468)
15. Guay J, Rivard GE,. Mediastinal bleeding after cardiopulmonary bypass in pediatric patients. Ann Thorac Surg 1996; 62 (6): 1955-1960. (Pubitemid 26421167)
16. Moganasundram S, Hunt BJ, Sykes K, et al. The relationship among thromboelastography, hemostatic variables, and bleeding after cardiopulmonary bypass surgery in children. Anesth Analg 2010; 110 (4): 995-1002.
17. Williams GD, Bratton SL, Riley EC, et al. Coagulation tests during cardiopulmonary bypass correlate with blood loss in children undergoing cardiac surgery. J Cardiothorac Vasc Anesth 1999; 13 (4): 398-404. (Pubitemid 29383895)
18. Nieuwenhuizen W,. Biochemistry and measurement of fibrinogen. Eur Heart J 1995; 16 (Suppl A): 6-10; discussion.
19. Gruenwald CE, Manlhiot C, Crawford-Lean L, et al. Management and monitoring of anticoagulation for children undergoing cardiopulmonary bypass in cardiac surgery. J Extra Corpor Technol 2010; 42 (1): 9-19.
20. Prisco D, Paniccia R,. Point-of-care testing of hemostasis in cardiac surgery. Thromb J 2003; 1 (1): 1.
21. Enriquez LJ, Shore-Lesserson L,. Point-of-care coagulation testing and transfusion algorithms. Br J Anaesth 2009; 103 (Suppl 1): i14-i22.
22. Miller BE, Guzzetta NA, Tosone SR, et al. Rapid evaluation of coagulopathies after cardiopulmonary bypass in children using modified thromboelastography. Anesth Analg 2000; 90 (6): 1324-1330. (Pubitemid 30351330)
23. Martin P, Horkay F, Rajah SM, et al. Monitoring of coagulation status using thrombelastography during paediatric open heart surgery. Int J Clin Monit Comput 1991; 8 (3): 183-187.
24. Jackson GN, Ashpole KJ, Yentis SM,. The TEG vs the ROTEM thromboelastography/thromboelastometry systems. Anaesthesia 2009; 64 (2): 212-215.
25. Venema LF, Post WJ, Hendriks HG, et al. An assessment of clinical interchangeability of TEG (R) and RoTEM (R) thromboelastographic variables in cardiac surgical patients. Anesth Analg 2010; 111 (2): 339-344.
26. Chavez JJ, Foley DE, Snider CC, et al. A novel thrombelastograph tissue factor/kaolin assay of activated clotting times for monitoring heparin anticoagulation during cardiopulmonary bypass. Anesth Analg 2004; 99 (5): 1290-1294; table of contents. (Pubitemid 39407270)
27. Chan KL, Summerhayes RG, Ignjatovic V, et al. Reference values for kaolin-activated thromboelastography in healthy children. Anesth Analg 2007; 105 (6): 1610-1613; table of contents. (Pubitemid 350190554)
28. Haizinger B, Gombotz H, Rehak P, et al. Activated thrombelastogram in neonates and infants with complex congenital heart disease in comparison with healthy children. Br J Anaesth 2006; 97 (4): 545-552. (Pubitemid 44419971)
29. Lang T, Johanning K, Metzler H, et al. The effects of fibrinogen levels on thromboelastometric variables in the presence of thrombocytopenia. Anesth Analg 2009; 108 (3): 751-758.
30. McEwan A,. Aspects of bleeding after cardiac surgery in children. Pediatr Anesth 2007; 17 (12): 1126-1133. (Pubitemid 350059099)
31. Nuttall GA, Oliver WC, Ereth MH, et al. Coagulation tests predict bleeding after cardiopulmonary bypass. J Cardiothorac Vasc Anesth 1997; 11 (7): 815-823. (Pubitemid 27523082)
32. Romlin SHWea,. Routine intraoperative thromboelastography reduces blood transfusions in paediatric cardiac surgery. J Cardiothorac Vasc Anesth 2009; 23 (3): S1.
33. Davidson SJ, McGrowder D, Roughton M, et al. Can ROTEM thromboelastometry predict postoperative bleeding after cardiac surgery? J Cardiothorac Vasc Anesth 2008; 22 (5): 655-661.
34. O'Shaughnessy DF, Atterbury C, Bolton Maggs P, et al. Guidelines for the use of fresh-frozen plasma, cryoprecipitate and cryosupernatant. Br J Haematol 2004; 126 (1): 11-28. (Pubitemid 38859478)
35. Murphy MF, Brozovic B, Murphy W, et al. Guidelines for platelet transfusions. British Committee for Standards in Haematology, Working Party of the Blood Transfusion Task Force. Transfus Med 1992; 2 (4): 311-318.
36. Contreras M, Ala FA, Greaves M, et al. Guidelines for the use of fresh frozen plasma. British Committee for Standards in Haematology, Working Party of the Blood Transfusion Task Force. Transfus Med 1992; 2 (1): 57-63.
37. Anderson L, Quasim I, Soutar R, et al. An audit of red cell and blood product use after the institution of thromboelastometry in a cardiac intensive care unit. Transfus Med 2006; 16 (1): 31-39.
38. Ak K, Isbir CS, Tetik S, et al. Thromboelastography-based transfusion algorithm reduces blood product use after elective CABG: a prospective randomized study. J Card Surg 2009; 24 (4): 404-410.
39. Avidan MS, Alcock EL, Da Fonseca J, et al. Comparison of structured use of routine laboratory tests or near-patient assessment with clinical judgement in the management of bleeding after cardiac surgery. Br J Anaesth 2004; 92 (2): 178-186. (Pubitemid 38159654)
40. Schochl H, Nienaber U, Hofer G, et al. Goal-directed coagulation management of major trauma patients using thromboelastometry (ROTEM)-guided administration of fibrinogen concentrate and prothrombin complex concentrate. Crit Care 2010; 14 (2): R55.
41. Stanworth SJ, Brunskill SJ, Hyde CJ, et al. Is fresh frozen plasma clinically effective? A systematic review of randomized controlled trials. Br J Haematol 2004; 126 (1): 139-152. (Pubitemid 38859495)
42. Kakkar N, Kaur R, Dhanoa J,. Improvement in fresh frozen plasma transfusion practice: results of an outcome audit. Transfus Med 2004; 14 (3): 231-235. (Pubitemid 38821562)
43. Alam HB, Bice LM, Butt MU, et al. Testing of blood products in a polytrauma model: results of a multi-institutional randomized preclinical trial. J Trauma 2009; 67 (4): 856-864.
44. Oliver WC Jr, Beynen FM, Nuttall GA, et al. Blood loss in infants and children for open heart operations: albumin 5% versus fresh-frozen plasma in the prime. Ann Thorac Surg 2003; 75 (5): 1506-1512. (Pubitemid 36515229)
45. McCall MM, Blackwell MM, Smyre JT, et al. Fresh frozen plasma in the pediatric pump prime: a prospective, randomized trial. Ann Thorac Surg 2004; 77 (3): 983-987; discussion 7. (Pubitemid 38271074)
46. Hellstern P,. Production and composition of prothrombin complex concentrates: correlation between composition and therapeutic efficiency. Thromb Res 1999; 95 (4 Suppl 1): S7-S12. (Pubitemid 29461042)
47. Hanley JP,. Warfarin reversal. J Clin Pathol 2004; 57 (11): 1132-1139. (Pubitemid 39486516)
48. Bershad EM, Suarez JI,. Prothrombin complex concentrates for oral anticoagulant therapy-related intracranial hemorrhage: a review of the literature. Neurocrit Care 2010; 12 (3): 403-413.
49. Fraser TA, Corke CF, Mohajeri M, et al. A retrospective audit of the use of Prothrombinex-HT for refractory bleeding following adult cardiac surgery. Crit Care Resusc 2006; 8 (2): 141-145.
50. Bruce D, Nokes TJ,. Prothrombin complex concentrate (Beriplex P/N) in severe bleeding: experience in a large tertiary hospital. Crit Care 2008; 12 (4): R105.
51. Bevan DH,. Cryoprecipitate: no longer the best therapeutic choice in congenital fibrinogen disorders? Thromb Res 2009; 124 (Suppl 2): S12-S16.
52. Dickneite G, Pragst I, Joch C, et al. Animal model and clinical evidence indicating low thrombogenic potential of fibrinogen concentrate (Haemocomplettan P). Blood Coagul Fibrinolysis 2009; 20 (7): 535-540.
53. Tziomalos K, Vakalopoulou S, Perifanis V, et al. Treatment of congenital fibrinogen deficiency: overview and recent findings. Vasc Health Risk Manag 2009; 5: 843-848.
54. Weinkove R, Rangarajan S,. Fibrinogen concentrate for acquired hypofibrinogenaemic states. Transfus Med 2008; 18 (3): 151-157. (Pubitemid 351847329)
55. Solomon C, Pichlmaier U, Schoechl H, et al. Recovery of fibrinogen after administration of fibrinogen concentrate to patients with severe bleeding after cardiopulmonary bypass surgery. Br J Anaesth 2010; 104 (5): 555-562.
56. Brenni M, Worn M, Bruesch M, et al. Successful rotational thromboelastometry-guided treatment of traumatic haemorrhage, hyperfibrinolysis and coagulopathy. Acta Anaesthesiol Scand 2010; 54 (1): 111-117.
57. Rahe-Meyer N, Pichlmaier M, Haverich A, et al. Bleeding management with fibrinogen concentrate targeting a high-normal plasma fibrinogen level: a pilot study. Br J Anaesth 2009; 102 (6): 785-792.
58. Rahe-Meyer N, Solomon C, Winterhalter M, et al. Thromboelastometry-guided administration of fibrinogen concentrate for the treatment of excessive intraoperative bleeding in thoracoabdominal aortic aneurysm surgery. J Thorac Cardiovasc Surg 2009; 138 (3): 694-702.
59. Karlsson M, Ternstrom L, Hyllner M, et al. Prophylactic fibrinogen infusion reduces bleeding after coronary artery bypass surgery. A prospective randomised pilot study. Thromb Haemost 2009; 102 (1): 137-144.
60. Fenger-Eriksen C, Ingerslev J, Sorensen B,. Fibrinogen concentrate-a potential universal hemostatic agent. Expert Opin Biol Ther 2009; 9 (10): 1325-1333.
61. Warren OJ, Rogers PL, Watret AL, et al. Defining the role of recombinant activated factor VII in pediatric cardiac surgery: where should we go from here? Pediatr Crit Care Med 2009; 10 (5): 572-582.
62. Ekert H, Brizard C, Eyers R, et al. Elective administration in infants of low-dose recombinant activated factor VII (rFVIIa) in cardiopulmonary bypass surgery for congenital heart disease does not shorten time to chest closure or reduce blood loss and need for transfusions: a randomized, double-blind, parallel group, placebo-controlled study of rFVIIa and standard haemostatic replacement therapy versus standard haemostatic replacement therapy. Blood Coagul Fibrinolysis 2006; 17 (5): 389-395. (Pubitemid 43941581)
63. Gill R, Herbertson M, Vuylsteke A, et al. Safety and efficacy of recombinant activated factor VII: a randomized placebo-controlled trial in the setting of bleeding after cardiac surgery. Circulation 2009; 120 (1): 21-27.
64. Godje O, Haushofer M, Lamm P, et al. The effect of factor XIII on bleeding in coronary surgery. Thorac Cardiovasc Surg 1998; 46 (5): 263-267. (Pubitemid 28562035)
65. Godje O, Gallmeier U, Schelian M, et al. Coagulation factor XIII reduces postoperative bleeding after coronary surgery with extracorporeal circulation. Thorac Cardiovasc Surg 2006; 54 (1): 26-33. (Pubitemid 43232140)
66. Levy JH, Gill R, Nussmeier NA, et al. Repletion of factor XIII following cardiopulmonary bypass using a recombinant A-subunit homodimer. A preliminary report. Thromb Haemost 2009; 102 (4): 765-771.
67. Ponce R, Armstrong K, Andrews K, et al. Safety of recombinant human factor XIII in a cynomolgus monkey model of extracorporeal blood circulation. Toxicol Pathol 2005; 33 (6): 702-710. (Pubitemid 43154597)
68. Blome M, Isgro F, Kiessling AH, et al. Relationship between factor XIII activity, fibrinogen, haemostasis screening tests and postoperative bleeding in cardiopulmonary bypass surgery. Thromb Haemost 2005; 93 (6): 1101-1107. (Pubitemid 40823515)
69. Brody JI, Pickering NJ, Fink GB,. Concentrations of factor VIII-related antigen and factor XIII during open heart surgery. Transfusion 1986; 26 (5): 478-480.
70. Wozniak G, Noll T, Akinturk H, et al. Factor XIII prevents development of myocardial edema in children undergoing surgery for congenital heart disease. Ann N Y Acad Sci 2001; 936: 617-620. (Pubitemid 32613946)
71. Schroth M, Meissner U, Cesnjevar R, et al. Plasmatic [corrected] factor XIII reduces severe pleural effusion in children after open-heart surgery. Pediatr Cardiol 2006; 27 (1): 56-60. (Pubitemid 43341077)
72. Fergusson DA, Hebert PC, Mazer CD, et al. A comparison of aprotinin and lysine analogues in high-risk cardiac surgery. N Engl J Med 2008; 358 (22): 2319-2331. (Pubitemid 351749156)
73. Mangano DT, Miao Y, Vuylsteke A, et al. Mortality associated with aprotinin during 5 years following coronary artery bypass graft surgery. JAMA 2007; 297 (5): 471-479.
74. Mangano DT, Tudor IC, Dietzel C,. The risk associated with aprotinin in cardiac surgery. N Engl J Med 2006; 354 (4): 353-365. (Pubitemid 43145060)
75. Henry D, Carless P, Fergusson D, et al. The safety of aprotinin and lysine-derived antifibrinolytic drugs in cardiac surgery: a meta-analysis. CMAJ 2009; 180 (2): 183-193.
76. Guzzetta NA, Evans FM, Rosenberg ES, et al. The impact of aprotinin on postoperative renal dysfunction in neonates undergoing cardiopulmonary bypass: a retrospective analysis. Anesth Analg 2009; 108 (2): 448-455.
77. Schouten ES, van de Pol AC, Schouten AN, et al. The effect of aprotinin, tranexamic acid, and aminocaproic acid on blood loss and use of blood products in major pediatric surgery: a meta-analysis. Pediatr Crit Care Med 2009; 10 (2): 182-190.
78. Tamás Breuer KM, Wilhelm M, Wiesner G, et al. Aprotinin is superior to tranexamic acid in paediatric cardiac surgery. J Cardiothorac Vasc Anesth 2008; 22 (3 Suppl): O-34.
79. Arnold DM, Fergusson DA, Chan AK, et al. Avoiding transfusions in children undergoing cardiac surgery: a meta-analysis of randomized trials of aprotinin. Anesth Analg 2006; 102 (3): 731-737.
80. Chauhan S, Bisoi A, Kumar N, et al. Dose comparison of tranexamic acid in pediatric cardiac surgery. Asian Cardiovasc Thorac Ann 2004; 12 (2): 121-124. (Pubitemid 39010972)
81. Cattaneo M, Harris AS, Stromberg U, et al. The effect of desmopressin on reducing blood loss in cardiac surgery-a meta-analysis of double-blind, placebo-controlled trials. Thromb Haemost 1995; 74 (4): 1064-1070.
82. Seear MD, Wadsworth LD, Rogers PC, et al. The effect of desmopressin acetate (DDAVP) on postoperative blood loss after cardiac operations in children. J Thorac Cardiovasc Surg 1989; 98 (2): 217-219. (Pubitemid 19198526)
83. Oliver WC Jr, Santrach PJ, Danielson GK, et al. Desmopressin does not reduce bleeding and transfusion requirements in congenital heart operations. Ann Thorac Surg 2000; 70 (6): 1923-1930. (Pubitemid 32015285)
84. Reynolds LM, Nicolson SC, Jobes DR, et al. Desmopressin does not decrease bleeding after cardiac operation in young children. J Thorac Cardiovasc Surg 1993; 106 (6): 954-958. (Pubitemid 24018536)