Rotational thromboelastometry predicts transfusion and disability in pediatric trauma.
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In brief
In brief
This retrospective study of 90 severely injured children demonstrates that ROTEM parameters can predict transfusion requirements and clinical outcomes. Specific thresholds for EXTEM clotting time and amplitude at 10 minutes were identified as indicators for packed red blood cell transfusion and disability risk.
Written by the GCMD Library team from the article.
BACKGROUND: Trauma-induced coagulopathy seen on rotational thromboelastometry (ROTEM) is associated with poor outcomes in adults; however, this relationship is poorly understood in the pediatric population. We sought to define thresholds for product-specific transfusion and evaluate the prognostic efficacy of ROTEM in injured children.
METHODS: Demographics, ROTEM, and clinical outcomes from severely injured children (age, < 18 years) admitted to a Level I trauma center between 2014 and 2018 were retrospectively analyzed. Receiver operating characteristic curves were plotted and Youden indexes were calculated against the endpoint of packed red blood cell transfusion to identify thresholds for intervention. The ROTEM parameters were compared against the clinical outcomes of mortality or disability at discharge.
RESULTS: Ninety subjects were reviewed. Increased tissue factor-triggered extrinsic pathway (EXTEM) clotting time (CT) >84.5 sec (p = 0.049), decreased EXTEM amplitude at 10 minutes (A10)