TEG Use in Children Undergoing Procedures With High Anticipated Blood Loss
Surgical Blood Loss, Surgical Hemorrhage, Post Operative Hemorrhage
About this trial
This is an interventional supportive care trial for Surgical Blood Loss focused on measuring thromboelastography, blood transfusion, viscoelastic test-guided, massive hemorrhage
Eligibility Criteria
Inclusion Criteria:
- Pediatric patients undergoing non-cardiac surgery at BCH with a high likelihood of blood transfusion. Specifically these are defined as a surgery with greater than 25% likelihood of transfusion of any non-albumin blood product.
- Eligible surgeries include:
- spinal surgery
- laparotomy
- liver transplant
- craniofacial surgery
- esophageal atresia
- craniotomy/hemispherectomy
- major abdominal surgery
- major hip surgery
- major plastic surgery
Exclusion Criteria:
- Patients undergoing cardiac surgery or ECMO cannulation, as these surgeries are generally considered outside the scope of general pediatric surgery.
- Patients presenting for emergent surgery
- Patients undergoing surgeries off hours (between 8pm and 8 am), when TEG analysis is unobtainable
Sites / Locations
Arms of the Study
Arm 1
Experimental
TEG Arm
All patients enrolled in the study will have up to four 0.5cc blood samples obtained specifically for TEG analysis at the following defined points (for a total of up to 2cc of blood) when other routine labs are drawn (via an existing intravenous line or arterial line placed for clinical care) : Once at the beginning of the case Once at the end of the case Up to two times at the same time as arterial blood gas (ABG) samples (if drawn) The research team will collect the following information from the electronic medical record and input it into the Internal REDCap database: De-identified demographic data, including age, height, weight, and diagnosis Preoperative, intraoperative, and postoperative laboratory values( including PT, PTT, INR and fibrinogen and platelets), as dictated by standard clinical practice Time of TEG results printed and time delivered to anesthesiologist Complications/Adverse events within the first 48 hours postoperatively