ORIGINAL ARTICLESEx-vivo response to blood products and haemostatic agents after paediatric cardiac surgeryHvas, Anne-Mette; Andreasen, Jo B.; Christiansen, Kirsten; Ravn, Hanne B.Author Information aDepartment of Clinical Biochemistry, Centre for Haemophilia and Thrombosis bDepartment of Anesthesiology and Intensive Care, Aarhus University Hospital, Aarhus, Denmark Correspondence to Anne-Mette Hvas, Centre for Haemophilia and Thrombosis, Department of Clinical Biochemistry, Aarhus University Hospital, Brendstrupgaardsvej 100, 8200 Aarhus N, Denmark Tel: +45 7845 5200; fax: +45 7845 5250; e-mail: email@example.com Received 14 September, 2012 Revised 27 January, 2013 Accepted 4 February, 2013 Blood Coagulation & Fibrinolysis: September 2013 - Volume 24 - Issue 6 - p 587-592 doi: 10.1097/MBC.0b013e32836029d2 Buy Metrics Abstract Bleeding complications after cardiac surgery are of particular importance in children because they are more prone to volume overload. To optimize haemostatic intervention, the coagulopathy has to be characterized, and knowledge about the effect of blood products and haemostatic agents is needed. The aims of the present study were to investigate changes in coagulation profiles after paediatric cardiac surgery and the effect after ex-vivo addition of blood products and haemostatic agents. Coagulation profiles were evaluated by thromboelastometry (ROTEM) in 54 children before and immediately after cardiac surgery. The haemostatic potential of various factor concentrates (fibrinogen concentrate, recombinant factor VIIa and factor XIII), fresh frozen plasma (FFP), pooled platelets and tranexamic acid was investigated. After surgery, the coagulation profiles revealed significantly prolonged clotting time (P = 0.008), and reduced clot propagation (P < 0.001) as well as reduced whole blood clot stability (P < 0.001). Ex-vivo addition of pooled platelets fully reversed the postoperative coagulopathy; this was also seen after addition of recombinant factor VIIa although less pronounced. Finally, addition of fibrinogen concentrate, FFP or tranexamic acid improved clot stability significantly. Whole blood coagulation was significantly impaired after cardiac surgery in children. Ex-vivo studies showed a total reversal of the coagulopathy after addition of pooled platelets and significantly improved clot stability after addition of fibrinogen concentrate, FFP and tranexamic acid, respectively. Copyright © 2013 YEAR Wolters Kluwer Health, Inc. All rights reserved.