alexa Perioperative Blood Loss In Children Undergoing Cardiac Surgery
ISSN: 2161-0665

Pediatrics & Therapeutics
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JOINT EVENT on 11th International Conference on Clinical Pediatrics & 2nd International Conference on Pediatric Surgery
June 29- July 01, 2017 London, UK

Ariane Willems
University Children’s Hospital Brussels, Belgium
Posters & Accepted Abstracts: Pediatr Ther
DOI: 10.4172/2161-0665-C1-040
Abstract
Cardiac surgery is a high bleeding risk surgery. Studying the predictive factors that are associated with bleeding in this specific population permits to detect the patients who are at high risk of bleeding and who will need early and adequate monitoring of their coagulation in order to be treated with appropriate blood products. First, we defined a simple probabilistic model including preoperative body weight, the presence of cyanotic heart disease, and the duration of wound closure to predict excessive post-operative blood loss in those children. It is also important to control the accuracy of the anticoagulation reversal practice. Current practice for heparin and protamine administration in children is mainly retrieved from adult coronary artery bypass graft surgery. Both residual heparin and protamine overdose are associated with increased postoperative bleeding. Different bedside assays, such as ACT and viscoelastic tests have been used to evaluate the presence of residual heparin after weaning from CPB in patients undergoing cardiac surgery. Second, we assessed the interchangeability of the ACT ± heparinase and ROTEM clotting time tests (INTEM/HEPTEM), for neutralization of heparin by protamine after separation of CPB in children undergoing cardiac surgery. We demonstrated that these tests are not interchangeable in the clinical setting. Clinicians should therefore know the advantages and disadvantages of used bedside tests and the results should be corroborated with the presence/absence of bleeding. Both studies are a prerequisite for the development of goal-oriented treatment algorithms for the management of the bleeding child undergoing cardiac surgery.
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