The relationship between coagulation and the extend of surgery and postoperative infection in surgical infants below 6 months of age

Kessler, Ulf; Guenther, Patrick; Zachariou, Zacharias (2006). The relationship between coagulation and the extend of surgery and postoperative infection in surgical infants below 6 months of age. Clinical hemorheology and microcirculation, 34(3), pp. 447-52. Amsterdam: IOS Press

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AIM: First to assess coagulation changes after surgery in children below 6 months of age. Second to detect differences attributable to the extent of surgery and postoperative infection. MATERIALS AND METHODS: Blood counts, haemoglobin concentration (Hb), haematocrit (Ht), prothrombine time (PT), activated partial thromboplastine time (aPTT) and thrombelastography (TEG) were studied pre- and 2+/-1/2 d postoperatively. Patients were divided in 3 groups. I: minor surgery without access to the abdomen or thorax (n=51); II: abdominal or thoracic interventions (n=24); III: abdominal surgery with postoperative sepsis (n=11). RESULTS: Preoperative values of Hb, Ht and INR were related to the age of the infant. Postoperatively clot strength and formation rate increased in gr. I (p<0.05). In gr. II, clot formation was initiated earlier (p<0.05) even though PT decreased (p<0.05). In group III, patients postoperatively developed a tendency for hypocoagulability in all TEG-parameters, but not in plasmatic coagulation. Postoperative TEG measurements were significantly inferior in gr. III when compared to gr. I and II. CONCLUSION: Our findings suggest activation of whole blood coagulation in the uncomplicated postoperative period despite of a decrease in plasmatic coagulation. In sepsis, only thrombelastography, but not plasmatic coagulation was affected.

Item Type:	Journal Article (Original Article)
Division/Institute:	04 Faculty of Medicine > Department of Gynaecology, Paediatrics and Endocrinology (DFKE) > Clinic of Paediatric Surgery
UniBE Contributor:	Kessler, Ulf, Zachariou, Zacharias
ISSN:	1386-0291
ISBN:	16614469
Publisher:	IOS Press
Language:	English
Submitter:	Factscience Import
Date Deposited:	04 Oct 2013 14:46
Last Modified:	05 Dec 2022 14:14
PubMed ID:	16614469
Web of Science ID:	000236715300009
URI:	https://boris.unibe.ch/id/eprint/19279 (FactScience: 1778)