Management of Dilutional Coagulopathy During Pediatric Major Surgery
Overview
Affiliations
Perioperative dilutional coagulopathy is a major coagulation disorder during adult and pediatric surgery. Although the main underlying mechanisms are comparable, data of the development and management of dilutional coagulopathy in children are scarce. Observational data showed that intraoperative coagulation disorders mainly based on complex disturbances of clot firmness including acquired fibrinogen as well as factor XIII deficiencies, while clotting time and platelet counts remained fairly stable. A fast and reliable monitoring of the entire coagulation process (e.g. thrombelastometry) might be of extreme value for detection and guidance of effective coagulation management. Although the transfusion of fresh frozen plasma was recommended in several guidelines, the use of coagulation factors might offer an alternative and potentially superior approach in managing perioperative coagulation disorders. Further studies are urgently needed to determine the efficacy of modern coagulation management.
Perioperative considerations in the paediatric patient with congenital and acquired coagulopathy.
Erdoes G, Goobie S, Haas T, Koster A, Levy J, Steiner M BJA Open. 2024; 12:100310.
PMID: 39376894 PMC: 11456917. DOI: 10.1016/j.bjao.2024.100310.
Patient Blood Management in Liver Transplant-A Concise Review.
Perez-Calatayud A, Hofmann A, Perez-Ferrer A, Escorza-Molina C, Torres-Perez B, Zaccarias-Ezzat J Biomedicines. 2023; 11(4).
PMID: 37189710 PMC: 10135593. DOI: 10.3390/biomedicines11041093.
Zarour S, Constantini S, Roth J, Friedman S, Kirgner I, Cohen B Eur J Pediatr. 2023; 182(3):1341-1349.
PMID: 36639535 DOI: 10.1007/s00431-023-04805-8.
Okoye H, Nwagha T, Ugwu A, Menuba I, Duru A, Ugwu E Afr Health Sci. 2022; 22(1):183-190.
PMID: 36032500 PMC: 9382527. DOI: 10.4314/ahs.v22i1.24.
Fahlbusch F, Heinlein T, Rauh M, Dittrich S, Cesnjevar R, Moosmann J PLoS One. 2018; 13(7):e0199240.
PMID: 29990321 PMC: 6038983. DOI: 10.1371/journal.pone.0199240.