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Predictors of Postoperative Bleeding in Pediatric Cardiac Surgery Under Cardiopulmonary Bypass: A Comparative Study of Thromboelastography Parameters and Central Laboratory Tests

Strategic Insights

— 1 min read

Research conducted by investigators at Aichi Children's Health and Medical Center aimed to compare the predictive value of thromboelastography parameters, including maximum amplitude of citrated functional fibrinogen (CFF-MA) and citrated rapid thromboelastography (CRT-MA), with central laboratory tests for early postoperative bleeding in pediatric cardiac surgery under cardiopulmonary bypass. The study found that CRT-MA and platelet count demonstrated the highest predictive ability for early postoperative bleeding, with an area under the curve (AUC) of 0.74.

Key Takeaways:

  • Predictive ability of thromboelastography parameters, including CFF-MA and CRT-MA, was evaluated using receiver operating characteristic (ROC) curve analysis.
  • CRT-MA and platelet count demonstrated the highest predictive ability for early postoperative bleeding in pediatric cardiac surgery under cardiopulmonary bypass (AUC 0.74, 95% CI 0.69-0.79).
  • CFF-MA outperformed serum fibrinogen (AUC 0.72 vs. 0.42, p < 0.01) in predicting postoperative bleeding.
  • The predictive value of CFF-MA and fibrinogen may diverge, especially in younger age groups.
  • A retrospective analysis was performed on 357 pediatric patients who underwent pediatric cardiac surgery under cardiopulmonary bypass.

Statistics:

  • 357 pediatric patients were included in the retrospective analysis.
  • 10% of estimated blood volume was transfused within 6 hours post-PICU admission.
  • AUC for CRT-MA and platelet count was 0.74 (95% CI 0.69-0.79).
  • AUC for CFF-MA was 0.72 (95% CI 0.66-0.77).
  • AUC for serum fibrinogen was 0.42.

Sources:

  • NewsRx. Investigators at Aichi Children's Health and Medical Center Zero in on Blood Coagulation Factors (Predictors of postoperative bleeding in pediatric cardiac surgery under cardiopulmonary bypass: a comparative study of thromboelastography ...). Pediatrics Week. November 1, 2025; p 588.
  • Predictors of postoperative bleeding in pediatric cardiac surgery under cardiopulmonary bypass: a comparative study of thromboelastography parameters and central laboratory tests. Journal of Anesthesia, 2025.

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