Functional maturity of the coagulation system in children: an evaluation using thrombelastography.

Abstract:

:There are quantitative deficiencies in the coagulation system for at least the first 6 mo of life. Clinical experience, however, does not indicate an increased risk of excessive bleeding during surgical procedures. Thrombelastography, a test providing a functional evaluation of coagulation, was used to assess the hemostatic system of pediatric patients under 2 yr of age. Thrombelastographic data were obtained from 237 healthy pediatric patients less than 2 yr of age undergoing elective noncardiac surgery. Five groups were distinguished: under 30 days, 1-3 mo, 3-6 mo, 6-12 mo, and 12-24 mo. Thrombelastography revealed no defects in coagulation when these groups were compared to each other or to adults, indicating a functionally intact hemostatic process even in neonates. Indeed, children less than 12 mo of age were found to initiate and develop clot faster than adults, with the coagulation process slowing to adult rates after 1 yr of age. In addition to defining functional integrity, our data represents a set of pediatric control thrombelastographic values that have not been previously reported and that may become important in understanding coagulation changes that accompany disease states and surgery in pediatric patients.

journal_name

Anesth Analg

journal_title

Anesthesia and analgesia

authors

Miller BE,Bailey JM,Mancuso TJ,Weinstein MS,Holbrook GW,Silvey EM,Tosone SR,Levy JH

doi

10.1097/00000539-199704000-00008

subject

Has Abstract

pub_date

1997-04-01 00:00:00

pages

745-8

issue

4

eissn

0003-2999

issn

1526-7598

journal_volume

84

pub_type

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