Christopher Durham, PharmD, BCPPS
Pediatric Critical Care Specialist
Wesley Medical Center, United States
Disclosure information not submitted.
Brian Gilbert, BCCCP, BCPS, MBA (he/him/his)
Emergency Medicine Clinical Pharmacy Specialist
Wesley Healthcare Center
Wichita, Kansas
Disclosure information not submitted.
Title: Evaluation of Thromboelastography in Pediatric Trauma
Introduction: Thromboelastography (TEG) is a viscoelastic test which measures the blood’s ability to form and break down clots. Thromboelastography has been shown to identify additional coagulopathies compared to conventional coagulation tests (CCTs) in adult trauma patients. There remains a paucity of evidence in the pediatric trauma population; therefore, the purpose of this study was to describe TEG parameters seen in a pediatric trauma cohort.
Methods: This single center, retrospective chart review evaluated pediatric level 1 trauma patients from January 2016 to June 2020. Patients included were less than seventeen years old, had an initial international normalized ratio value, prothrombin time, fibrinogen and TEG value obtained within 3 hours of admission.
Results: Ninety-eight patients met inclusion criteria. Of the 98 patients included, approximately 51% had an abnormal activated clotting time, 27% had an abnormal R time, 8% had an abnormal K value, 14% had an abnormal alpha angle and 17% had an abnormal maximum amplitude (MA). When evaluating the twenty-three patients that received blood products, 91% had at least one abnormal TEG value while 87% had at least one abnormal CCT. Of the 18 patients that died, 83% had at least one abnormality in both TEG and CCTs.
Conclusions: In this pediatric trauma cohort increased K value and decreased MA had higher incidences of death compared to CCTs. A larger data set is needed to further validate the utility of TEG in pediatric trauma.