Supervisors info:
Σερένα Βαλσάμη, Αναπληρώτρια Καθηγήτρια, Ιατρική Σχολή, ΕΚΠΑ
Παρασκευή Ματσώτα, Ομότιμη Καθηγήτρια, Ιατρική Σχολή, ΕΚΠΑ
Ιωάννης Κουτελέκος, Αναπληρωτής Καθηγητής, Τμήμα Νοσηλευτικής, ΠΑΔΑ
Summary:
Pediatric surgery is a specialized branch of medicine that deals with surgical procedures performed on children, from newborns to teenagers. A critical aspect of pediatric surgery is the effective management of hemostasis and coagulation to prevent excessive bleeding or thrombotic complications. Thromboelastography and thromboelastometry are valuable tools in this context, offering real-time information about patients’ hemostatic profile. The purpose of this study is to review the use of thromboelastography and thromboelastometry in children and infants undergoing surgery.
A systematic review of the literature was performed using the Pubmed database. Studies were searched using the following keywords: ("thromboelastography" OR "TEG" OR "thromboelastometry" OR "ROTEM") AND ("children" OR "infants" OR "infant" OR "pediatric") AND ("surgery" OR "surgical"). We searched for clinical studies reporting on the perioperative use of thromboelastography and thromboelastometry in infants and children undergoing surgery. Systematic reviews, case reports, animal studies, conference presentations, book chapters, research protocols and studies in languages other than English were excluded from the review.
Initially, 222 studies were identified after the primary search of the online Pubmed database. After screening titles and abstracts, 173 studies were rejected, leaving 49 articles for evaluation. Among them, 8 studies (case reports, review studies) were rejected. Finally, 41 studies remained for final analysis. In children, thromboelastography and thromboelastometry are mainly used in cardiac surgery with cardiopulmonary bypass, to prevent bleeding and thrombotic events and to guide transfusion therapy. In addition, in children, thromboelastography and thromboelastometry are used in surgical corrections of congenital craniosynostosis, intracranial tumor removals, spinal fusions, and liver transplants.
Recently, apart from pediatric cardiac surgery, thromboelastography and thromboelastometry have been successfully applied to children undergoing craniofacial, neurosurgical, orthopedic operations as well as liver transplantation. However, the specific use of thromboelastography and thromboelastometry and the interpretation of its results may vary depending on the patient's condition and the surgical procedure. It is always important for a specialized medical team to integrate thromboelastographic data into the overall clinical assessment and decision-making process.
Keywords:
Thromboelastography, Thromboelastometry, Coagulation, Hemostasis, Pediatric surgery
