Intraoperative Thromboelastography-activated Clotting Time After Weaning From Cardiopulmonary Bypass Correlates With Fibrinogen Concentration, and Its Prolongation May Predict Hypofibrinogenemia.

Authors

Mayuko Inaba, Nobuko Ohashi, Yutaka Seino, Hiroshi Baba

Published in

Journal of cardiothoracic and vascular anesthesia. Aug 09, 2026. Epub Aug 09, 2026.

Abstract

To investigate the clinical significance of thromboelastography-activated clotting time (T-ACT) measured after weaning from cardiopulmonary bypass (CPB), particularly its potential to predict the need for blood transfusion and guide transfusion strategies in pediatric cardiac surgery.
Retrospective observational study.
A single tertiary university hospital operating room.
218 pediatric patients aged <7 years scheduled for elective cardiac surgery using CPB.
After weaning from CPB and protamine administration, thromboelastography analysis and laboratory tests (including coagulation and blood count tests) were performed. Univariate analysis using the Spearman rank correlation coefficient was employed to evaluate associations between T-ACT and intraoperative patient and surgical variables measured after weaning from CPB. T-ACT showed negative correlations with platelet count, fibrinogen levels, prothrombin time, citrated rapid thromboelastography maximum amplitude, and citrated functional fibrinogen maximum amplitude. Multivariate regression using the forced-entry method included variables with p < 0.10 in the univariate analyses. The fibrinogen level, prothrombin time, and citrated functional fibrinogen maximum amplitude were statistically significant (p < 0.05). Hypofibrinogenemia detection was identified as particularly important for predicting coagulation disorders after weaning from CPB. Receiver operating characteristic analysis of T-ACT for discriminating intraoperative fibrinogen ≤150 mg/dL yielded a cutoff value of 158.1 seconds (area under the curve: 0.84; p < 0.0001).
In pediatric patients undergoing cardiac surgery with CPB, intraoperative T-ACT measured after weaning from CPB correlated with fibrinogen concentration, and T-ACT prolongation may discriminate hypofibrinogenemia.

PMID:
42649009
Bibliographic data and abstract were imported from PubMed on 27 Aug 2026.

Read full publication at:
Please sign in to see all details.

Stats

1-terrible, 9-excellent. How would you rate this publication? Sign in in to submit your rating.

Post a comment

You need to be signed in to post comments. You can sign in here.

Comments

There are no comments yet.