Celite-activated thrombelastography in children

Study Objective: To quantify global coagulation and establish normal ranges for the celite-activated thrombelastograph ^R (TEG) in healthy pediatric patients. Design: Prospective observational study. Setting: Operating suite of a university-based hospital.Patients: 110 healthy pediatric patients in four age groups and 25 healthy adult patients.Interventions: Blood sampling for the celite-activated TEG was carried out after anesthetic induction. Measurements: TEG indices: R time (reflecting time to fibrin formation), K time and alpha angle (fibrinogen-platelet interaction), maximum amplitude (reflecting maximal clot strength, platelet and fibrinogen function), TEG index (mathematical incorporation of the prior four measurements), and percent fibrinolysis at 30 minutes, were all recorded. Main Results: Statistically significant differences between <12-month group in angle (compared to 25-48 month group) and % fibrinolysis (compared to all other pediatric groups). Significant differences in angle between two pediatric groups and adult group, and in the TEG index between three pediatric groups and adult group (all differences p < 0.05). Conclusions: These data identify changes of small magnitude in three celite-TEG parameters in healthy children compared to adults, without implication of abnormal coagulation between groups. Changes do not seem to be consistently related to age and will be useful for clinicians using the TEG to monitor (ab) normal coagulation in pediatric patients.