Cardiothoracic & vascular anesthesia
Thrombin Generation in Pediatric Cardiac Surgery Patients: A Prospective Single-center Cohort Study
Authors' conclusion
In children undergoing cardiac surgery, thrombin generation assay revealed significant and persistent decline in endogenous thrombin potential after cardiopulmonary bypass, despite hemostatic interventions.
Study context
- Population
- Children undergoing cardiac surgery with CPB (median age 6.3 months; 68.5% <10 kg)162 plasma samples
- Participants
- 54 children
- Exposure
- Endogenous thrombin potential (ETP) after protamine and at sternal closure vs baseline
- Outcome
- Change in endogenous thrombin potential (ETP) across three measurements before and after CPB
Methodological detailssingle-center, Enrolment August 2022 to May 2024
- Single-center
- Enrolment August 2022 to May 2024
Main finding
As reported in the abstract
Mean decrease
1,911 nM
95% CI 1,655–2,168P < 0.001
After protamine
Mean decrease
1,865 nM
95% CI 1,609–2,122P < 0.001
Sternal closure
Observational data: associations, not effects.
Further findings
Secondary thrombin generation parameters
- Similar changes observed
Unfractionated heparin activity · all three time points
- Median activity less than 0.1 U/ml
Correlation of ETP after protamine with transfusion volume after bypass
- Strong negative correlation (ρ)
- ρ = −0.52, P < 0.001
Predictors of ETP decline (five factors examined)
- Only total heparin dose independently associated; higher dose predicted greater ETP decline
- P = 0.002
Original publication
Composed by AI from the published abstract and checked against it. How Briefs are made →