Modern diagnostics and complex correction of hemorrhagic disorders in children with congenital heart diseases
The purpose of our studywas to investigate the functional state of hemostasis and fibrinolysis in children with “cyanotic” CHD before and after surgery.
It has been studied the hemostatic system in children with “cyanotic” and “pale” CHD in the perioperative period. Coagulation disorder was evaluated by low-frequency vibration of the piezoelectric thromboelastography (LVPT), the results of which were compared with healthy children.
On admission in the children with “cyanotic” CHD were observed hypercoagulable change due to the vascular-platelet and coagulation link of hemostasis. At the end of the intraoperative period, in the children of this group there is a pronounced phenomenon of structural and chronometric hypocoagulation due to the coagulation link of hemostasis. At the same time the indices of the vascular-platelet and fibrinolytic components of hemostasis were not significantly different from the level of healthy children. Correction of the hemostatic system was conducted individually, based on the results of LVPT.
Timely diagnosis and correction of the hemostatic system helped minimize the blood loss in children with “cyanotic” CHD.
2. Schobersberger W. Interaction of hypoxia and haemostasis – hypoxia as a prothrombotic factor at high altitude? / W. Schobersberger, G. Hoffmann, H. C. Gunga // Wien Med.Wochenschr. – 2005. – Vol. 155 (7–8). – P. 157–162.
3. Rate of abnormalities coagulation test results in patients with congenital heart disease / M. T. Arslan, M. Ozcetin, R. Ozyurek [et al.] // Journal of contemporary medicine. – 2011. – Vol. 1. – P. 6–10.
4. Шахматов И. И. Состояние системы гемостаза при различных видах гипоксического воздействия / И. И. Шахматов, В. М. Вдовин, В. И. Киселев // Бюллетень СО РАМН. – № 2. – 2010. – С. 131–138.
5. Puspitasari F. Hyperviscoucity in cyanotic conginetal heart disease / F. Puspitasari, G. Harimurt // J. Kardiol. Indones. – 2010. – Vol. 31. – P. 41–47.
6. Activated thrombelastogramin neonatesand infantswith complex congenital heart diseasein comparisonwith healthy children / Haizinger B., Gombotz H., Rehak P. [et al.] // J. Anaesth.– 2006. – Vol. 97 (4). – P. 545–52.
7. Характеристика системы гемостаза у кардиохирургических пациентов первого года жизни с врожденными пороками сердца / Н. Н. Самсонова, Е. Ф. Козар, М. Г. Плющ [и др.] // Детские болезни сердца и сосудов. – 2005. – № 4. – С. 54–58.
8. Faraoni D. Factors affecting postoperative blood loss in children undergoing cardiac surgery / D. Faraoni, P. Van der Linden // Journal of Cardiothoracic Surgery. – 2014. – Vol. 9. – P. 32.