Abstract

Background: A recent systematic review and meta-analysis was undertaken to determine the impact of transfusion goal directed protocols with viscoelastic methods on postoperative outcome in pediatric hemorrhagic surgery. This trial revealed that fresh frozen plasma transfusion and length of hospital stay were reduced in the group where transfusion was guided with point of care viscoelastic methods. A transfusion goal directed protocol with rotational thromboelastometry sigma is in preparation (ROTEM sigma). Since the actual. ROTEM parameters were determined with ROTEM delta, we would like to validate pediatric. parameters with ROTEM sigma. Once these parameters are validated in this trial they will be integrated in the pediatric transfusion protocol guided with ROTEM sigma in hemorrhagic surgery.

Objectives: The primary objective is to determine pediatric ROTEM sigma parameters predictive of intraoperative and postoperative transfusion. The secondary objectives are to determine pediatric ROTEM sigma parameters predictive of intraoperative and postoperative blood loss, postoperative length of intensive care stay (LOSICU), length of mechanical ventilation (LMV) and length of hospital stay (LOS).

Methods: Patients aged less than 18 years old admitted for potential hemorrhagic surgery. The study will be monocentric. Statistic analysis will be realized with XLSTAT 2018.3 or plus software.

Conclusion: This pilot study will determine pediatric ROTEM sigma parameters predcitive of intraoperative and postoperative transfusion, blood loss and postoperative LOSICU, LMV and LOS which will be integrated in a transfusion goal directed protocol guided with ROTEM sigma.

Keywords: Transfusion Goal Directed Protocol; ROTEM Sigma; Children; Outcome

References

1. Kumba C., et al. “Systematic Review and Meta-analysis of Goal Directed Intra-Operative Transfusion Protocols Guided by Viscoelastic Methods and Perioperative Outcomes in Children”. International Journal of Recent Scientific Research 10.3 (2019): 31466-31471.
2. Wikkelso A., et al. “Thromboelastography (TEG) or thromboelastometry (ROTEM) to monitor haemostatic treat versus usual care in adults or children with bleeding”. Cochrane Database of Systematic Reviews (2016).
3. Kumba C., et al. “Transfusion and Morbi-Mortality Factors: An Observational Descriptive Retrospective Pediatric Cohort Study”. Journal of Anesthesia and Critical Care: Open Access 8.4 (2017): 00315. 
4. Oswald E., et al. “Thromboelastometry (ROTEM) in children: age-related reference ranges and correlations with standard coagulation tests”. British Journal of Anaesthesia 105.6 (2010): 827-835.
5. Kumba C. “Do goal directed therapies improve postoperative outcome in children? (Perioperative goal directed fluid and hemodynamic therapy; Transfusion goal directed therapy using viscoelastic methods and enhanced recovery after surgery and postoperative outcome): A study research protocol”. Acta Scientific Paediatrics 2.7 (2019) :17-19.

Citation

Citation: Kumba C and Tréluyer JM. "Pediatric Rotem Sigma Parameters in Potential Perioperative Hemorrhagic Surgery: An, Prospective Pilot Study Protocol Observational Prospective Pilot Study Protocol".Acta Scientific Paediatrics 4.1 (2020): 31-33.

Copyright

Copyright: © 2020 Kumba C and Tréluyer JM. This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.