Recently, the Chinese National Health and Medical Commission issued national standards such as the "Guidelines for Pediatric Blood Transfusion" and "Guidelines for Blood Management of Perioperative Patients". Thromboelastography, as a diagnostic device that can detect all elements of the whole coagulation process and evaluate the coagulation state as a whole, has been included in the national standards. .
1 The key elaboration of thromboelastometry in the "Guidelines for Pediatric Blood Transfusion"
10.1.3 For children with high bleeding risk and long cardiopulmonary bypass time, von Willebrand disease testing should be performed. When necessary, blood coagulation factor level detection or thromboelastography should be added.
10.2.6 If there is still a lot of bleeding after protamine antagonism, thromboelastography should be used to evaluate the hemostatic state to guide treatment.
10.3.3 Indications for FFP Infusion
2 The key elaboration of thromboelastography in the "Guidelines for Blood Management in Perioperative Patients"
7.6 For patients with severe bleeding, viscoelastic coagulation testing methods (such as thromboelastography, etc.) should be used, and goal-directed therapy should be performed according to the testing results.
9.2.2 Platelet Transfusion
When the patient is bleeding and associated with abnormal platelet function (eg, thromboelastography suggests low platelet function), platelet transfusion is not limited by the recommended transfusion threshold range.
9.3.2 Indications for fresh frozen plasma transfusion:
Patient is bleeding, excluding hypothermia, acidosis and other conditions, when PT and/or APTT is greater than 1.5 times the mean of the normal range, INR is greater than 1.7, and thromboelastography indicates coagulation factor deficiency;
9.4.2 Indications for cryoprecipitate coagulation factor transfusion:
Plasma fibrinogen < 1.0g/L, thromboelastography indicates low fibrinogen function;