Thrombocytopenia related to multiple organ failure (TAMOF) related to extracorporeal circulation in cardiac surgery in paediatrics

Abstract

Aims and objectives: To determine the frequency of thrombocytopenia associated multi organ failure without infection criteria and its impact on the evolution and survival of patients undergoing cardiac surgery with extracorporeal circulation and prognosis. Methods : Longitudinal, prospective, observational study to determine the frequency in the presentation of thrombocytopenia associated with multiple organ failure in patients undergoing cardiac surgery under extracorporeal circulation without positive infection rates, admitted to the intensive care unit surgical (ICU). and its impact in the evolution of these patients in the Hospital Federico Gómez. Results: A total of 47 patients under extracorporeal circulation were analysed. Proportion for low cardiac output syndrome 23% (n = 11) being this complication most frequent presented by our patients, with a direct relationship to the appearance of TAMOF with a p <0.05, there is a direct relationship between the appearance of TAMOF in patients with> 140 minutes of extracorporeal circulation time, the presence of deep hypothermia, lactate more than 5 mmol / L on admission, a PSOFA score of more than 8 points, and a higher score on the RASCH risk scale with a p <0.05. There was a significant difference with a p <0.05 in the days of stay in therapy intensive, and mortality among patients who developed TAMOF and those who did not. Conclusions: The incidence of TAMOF associated with extracorporeal circulation during cardiac surgery in children and its role in impoverishment within the prognosis makes it important to identify this entity to establish action measures with appropriate therapies for these patients. It is it is necessary to normalize the ADAMTS 13 activity tests in children undergoing extracorporeal circulation.