Comparison of thromboelastography and routine coagulation tests for evaluation of blood coagulation in critically ill children / 中国小儿急救医学

ABSTRACT

Objective:To investigate the correlation and consistency between the parameters of the thromboelastography(TEG) and of routine coagulation tests and platelet count(PLT) in critically ill children in the pediatric intensive care unit.Methods:We conducted a retrospective analysis on the results of the simultaneous TEGs, coagulation tests and PLT of 231 children in pediatric intensive care unit at Children′s Hospital Affiliated to Fudan University from March 2019 to July 2019, including the correlation analysis, the chi-square test and Kappa consistency analysis.Results:The reaction time(R) was linearly dependent on activated partial thromboplastin time(APTT), prothrombin time(PT) and thrombin time(TT), respectively.The maximal amplitude(MA), clot time formation(K) and alpha-angle(α) were linearly dependent on fibrinogen.The MA, K and α were linearly dependent on PLT, too.And the correlation between MA and PLT was the best( R=0.656). There were significant differences( P<0.001) and poor consistency(Kappa value 0.112, 0.047, 0.124) between R and APTT, PT, TT.There was no significant difference( P>0.05) and there was moderate consistency(Kappa value 0528, 0.518, 0.408) between Ma, K, α and PLT.There were significant differences( P<0.001) and the consistency was poor or fair(Kappa value 0.324, 0.188, 0.170) between Ma, K, α and fibrinogen. Conclusion:TEG is significantly correlated with PLT in evaluating platelet function and the consistency is good.The TEG parameters are linearly correlated with the relevant results of routine coagulation tests in evaluating the coagulation factor and fibrinogen function, but consistency is weak.Therefore, it is concluded that these two methods are irreplaceable.