A prognostic model for thrombotic complications after pediatric cardiac surgery

• DOI: 10.15690/rpj.v1i4.2190
• Publication Date: 2021-01-16T13:31:27Z
• Authors: Vasily A. Lastovka; Rustem F. Tepaev; Olga B. Gordeeva; Anuar R. Bidzhiev
• Keywords: 03 medical and health sciences; 0302 clinical medicine; 3. Good health

Background . Cardiac surgery performed on pediatric patients with the use of artificial blood circulation (ABC) is accompanied by hemodilution, hypothermia and contact surfaces, as well surgical trauma. All above lead to endothelial cell injury, platelet aggregation degranulation, activation innate immunity, development systemic inflammation consumption clotting, anti-coagulation fibrinolytic factors, which ultimately associated occurrence thrombotic complications. Objective The study aimed at developing a mathematical model for prognosis complications in children had undergone ABC, based assessment their clinical laboratory parameters. Methods We have assessed data obtained from 153 (newborn 11 months 29 days age) cardiac under conditions ABC due congenital heart defects (CHD). For all general parameters: complete count, comprehensive metabolic panel, parameters screening coagulogram, D-dimer concentration, von Willebrand factor activity, levels antithrombin III, plasminogen, protein C S, alpha-2-antiplasmin, thrombin activatable fibrinolysis inhibitor (TAFI) fibrin-monomer been assessed. Results In 43 (28.1%) post-operative thromboses diagnosed. Examination revealed presence thrombosis various localization including intracardiac thrombi, ischemic cerebrovascular events, limb ischemia, etc. Based logistic regression analysis, has built included 4 activity lactate dehydrogenase (LDH), TAFI activity. Model sensitivity was 95.3%, its specificity — 96.4%.