• Audrey Dieu, Victoria Van Regemorter, Thierry Detaille, Laurent Houtekie, Stéphane Eeckhoudt, Céline Khalifa, David Kahn, Stéphan Clement De Clety, Alain Poncelet, and Mona Momeni.
• Department of Anesthesiology, Cliniques Universitaires Saint Luc, Université Catholique de Louvain, Brussels, Belgium.
• J. Cardiothorac. Vasc. Anesth. 2021 Jul 1; 35 (7): 2115-2123.

ObjectivesFew studies have investigated the Multiplate platelet function analyzer in pediatrics. The authors evaluated Multiplate combined with Rotem in terms of guiding platelet transfusion after pediatric cardiac surgery with cardiopulmonary bypass (CPB). The authors further compared coagulation parameters between cyanotic and acyanotic patients.DesignSubgroup analysis of a randomized clinical trial.SettingTertiary hospital.ParticipantsPatients weighing between seven and 15 kg.InterventionsNone.Measurements And Main ResultsRotem and Multiplate tests were performed (1) after anesthesia induction, (2) upon CPB separation, and (3) upon intensive care unit arrival. Among a total of 59 subjects, 9 patients required platelet transfusion. In multivariate linear regression, analysis EXTEM maximum clot firmness upon CPB separation was associated with the volume of transfused platelets (regression coefficient = -0.348 [95% confidence interval -1.006 to -0.028]; p = 0.039). No such association was found for the Multiplate test. Acyanotic and cyanotic heart disease were present in 32 and 27 children, respectively. There were no significant differences between these two groups in terms of platelet count and function. Postoperative blood loss was significantly higher in the cyanotic group compared with the acyanotic arm (p = 0.015; difference [95% confidence interval -2.40 {-4.20 to -0.60}]). There were no differences between groups regarding transfusion of allogeneic blood products.ConclusionsThis study showed that Rotem, but not Multiplate results, were associated with platelet transfusion in pediatric cardiac surgery with no intake of platelet inhibitors. The usefulness of combining these tests in platelet transfusion decision-making needs to be evaluated in larger populations.Copyright © 2020 Elsevier Inc. All rights reserved.

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