An attempt for prediction of postoperative drainage volume in pediatric cardiac surgery using parameters of preoperative global coagulation test

  • Dr Tamaki Hayashi, Department of Pediatrics, Nara Medical University, Japan
  • Dr Yoshihiko Sakurai, Department of Pediatrics, Nara Medical University, Japan
  • Dr Kazuyoshi Fukuda, Department of Pediatrics, Nara Medical University, Japan
  • Dr Midori Shima, Department of Pediatrics, Nara Medical University, Japan
  • Dr Yoshiro Yoshikawa, Department of Thoracic and Cardiovascular Surgery, Nara Medical University, Japan

    • Coagulopathies after cardiac surgery are complex and its influences to the clinical condition remain unclear. The aim of this study was to determine if there is a direct relationship between coagulation parameters and postoperative chest tube drainage (CTD). The coagulation factors were analyzed before and 24 hours after cardiac surgery in 20 patients with congenital cardiac disease. The parameters included platelet count, hematocrit, prothrombin time, activated partial thrombin time, thrombin-antithrombin complex (TAT), Rotation thromboelastometry (ROTEM) parameters (clotting time (CT), clot formation time (CFT), maximum clot firmness (MCF), max velocity (maxVel), time to max velocity (t-maxVel), area under curve (AUC)), thrombin generation test (TGT) parameters (peak height (Peak),time to peak (ttPeak), endogenous thrombin potential (ETP), and operation time. Platelet count decreased and TAT increased after operation significantly. MCF and AUC altered significantly but there were no obvious change in TGT. Results of classical coagulation tests had no correlation with CTD. However, preoperative ETP and CFT, postoperative TAT, Peak, ETP, CFT, α, maxVel, MCF, and AUC, and operation time correlate with CTD. Furthermore, there was a correlation between operation time and ROTEM parameters Our findings suggested that these parameters would be useful in predicting the postoperative bleeding risk.