Thromboelastography-does it impact blood component transfusion in pediatric heart surgery?

Lauren C. Kane, Cathy S Woodward, Syed Adil Husain, Melissa J Frei-jones

Research output: Contribution to journalArticle

21 Citations (Scopus)

Abstract

Background: The administration of blood products during pediatric cardiac surgery is common. We sought to determine if thromboelastography (TEG) is a cost-effective tool to reduce blood product transfusion in open pediatric cardiac surgery. Materials and methods: A retrospective case-control study was undertaken for 150 pediatric cardiac patients requiring cardiopulmonary bypass from January 2010-May 2012, in a University-affiliated pediatric hospital. Fifty sequential patients operated on when TEG was used were compared with 100 control patients before TEG availability. Groups were matched 2:1 for age and risk adjustment for congenital heart surgery score. Blood product utilization was compared between groups, as were outcomes metrics such as postoperative complications, length of stay, and hospital costs of transfusions. Results: Demographic variables, risk adjustment for congenital heart surgery score classifications, and cardiopulmonary bypass times were similar between groups. Red cell and plasma transfusion were comparable between groups. TEG patients saw a substantial reduction in the administration of platelet (1 versus 2.2 U; P < 0.0001) and cryoprecipitate (0.7 versus 1.7 U; P < 0.0001) transfusions. A greater than 50% reductions in hospital costs of platelet ($595 versus $1309) and cryoprecipitate ($39 versus $94) transfusions were observed in the TEG group. Mortality, length of stay, ventilator requirements, postoperative bleeding, and thrombotic events were equivalent. Conclusions: Intraoperative TEG use reduced platelet and cryoprecipitate transfusions without an increase in postoperative complications. TEG is a cost-effective method to direct blood product replacement.

Original languageEnglish (US)
JournalJournal of Surgical Research
DOIs
StateAccepted/In press - Mar 18 2015

Fingerprint

Blood Component Transfusion
Thrombelastography
Thoracic Surgery
Pediatrics
Risk Adjustment
Hospital Costs
Cardiopulmonary Bypass
Length of Stay
Blood Platelets
Costs and Cost Analysis
Platelet Transfusion
Pediatric Hospitals
Mechanical Ventilators
Plasma Cells
Blood Transfusion
Case-Control Studies
Research Design
Demography
Hemorrhage
Mortality

Keywords

  • Bleeding
  • Bleeding control
  • Cardiopulmonary bypass
  • Coagulopathy
  • Congenital heart disease
  • Thromboelastography
  • Thrombosis

ASJC Scopus subject areas

  • Surgery

Cite this

Thromboelastography-does it impact blood component transfusion in pediatric heart surgery? / Kane, Lauren C.; Woodward, Cathy S; Husain, Syed Adil; Frei-jones, Melissa J.

In: Journal of Surgical Research, 18.03.2015.

Research output: Contribution to journalArticle

Kane, Lauren C. ; Woodward, Cathy S ; Husain, Syed Adil ; Frei-jones, Melissa J. / Thromboelastography-does it impact blood component transfusion in pediatric heart surgery?. In: Journal of Surgical Research. 2015.
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