Abstract Number: PB0243
Meeting: ISTH 2022 Congress
Background: PLTEM is a useful parameter to directly assess the platelet component in clot formation in CS patients. In previous study, PLTEM cut-off values were calculated for platelet counts (PLT) of 50000 and 100000/mm3 in pediatric patients.
Aims: To validate cut-off values, sensitivity, specificity, positive and negative predictive values (PPV and NPV, respectively) of the PLTEM in neonates weighing < 5Kg undergoing CS for PLT of 50000 and 100000/mm3.
Methods: Population: consecutive neonate CS patients (period: October 2020-September 2021). Samples were drawn at Basal (B), before termination of extracorporeal circulation (ECC) and after administration of protamine (PostProtamine).
Thromboelastometry ROTEM® delta (Instrumentation Laboratory, IL) results were used to calculate PLTEM: EXTEM amplitude at 10 minutes (A10) minus FIBTEM A10.
PLT: HemoCell CXH800 (Beckman Coulter)
Statistical evaluation: SPSS 23 software.
Results: 32 patients. Age: median (IQR) 19 (6-26) days; Weight: median 3350 (3055-3785) grams.
Significant positive correlation between PLTEMA10 and PLT was observed at all surgical stages (table 1), reaching a plateau at normal PLT (Image 1). This correlation was strongest at lower PLT.
Sensitivity, specificity, PPV and NPV were calculated for two different PLT cut-off values: < 100000/mm3 and < 50000/mm3 considering two levels of fibrinogen (FIBTEMA10 < 10 and >10 mm), all patients with hematocrit >30% (table 1). Very high NPV (all >95%) were observed regardless of PLT or FIBTEMA10, while for PPV, higher values were observed when PLT < 100000/mm3, and slightly lower for PLT < 50000/mm3. (table 1)
Conclusion(s): Previously established PLTEMA10 cut-off for the pediatric population was validated in < 5kg neonates undergoing CS. Results show that PLTEM is useful to estimate patient’s PLT and detect thrombocytopenia during CS, with good sensitivity, specificity and NPV. Furthermore, the performance is better in more severe thrombocytopenia (PLT < 50000/mm3). Timely detection of thrombocytopenia may allow early intervention as well as avoidance of unnecessary platelet transfusion.
To cite this abstract in AMA style:
Lopez M, Mileo F, Rossi P, Vainstein T, Barrera L, Martinuzzo M. Validation of the PLTEMA10 in Cardiac Surgery (CS) neonatal population weighing less than 5 Kg [abstract]. https://abstracts.isth.org/abstract/validation-of-the-pltema10-in-cardiac-surgery-cs-neonatal-population-weighing-less-than-5-kg/. Accessed March 21, 2024.« Back to ISTH 2022 Congress
ISTH Congress Abstracts - https://abstracts.isth.org/abstract/validation-of-the-pltema10-in-cardiac-surgery-cs-neonatal-population-weighing-less-than-5-kg/