Boston Children’s TEG Coagulation Laboratory focuses on improving the prediction and management of perioperative bleeding and thrombosis in pediatric patients undergoing complex cardiac surgery and extracorporeal membrane oxygenation (ECMO). Our research evaluates advanced coagulation monitoring tools to support evidence-based, goal-directed hemostatic management across these high-risk patient populations.
Areas of focus include:
- Assessment of existing FDA approved point-of-care diagnostic testing devices to improve customized anticoagulation management for cardiac patients
- Development of novel point-of-care coagulation diagnostic tools currently unavailable in clinical practice
- Identification of key areas for clinical investigation, including prospective and retrospective coagulation studies
As part of this work, we validated multiple thromboelastography (TEG) platforms, including the mechanical TEG5000 and the point-of-care optical TEG6S platforms. Our findings demonstrate that viscoelastic-guided transfusion strategies are associated with improved bleeding control and reduced exposure to unnecessary blood products. Additionally, viscoelastic parameters indicative of reduced clot strength during surgery were associated with increased bleeding risk, while distinct coagulation profiles observed in patients receiving extracorporeal support suggested a propensity toward hypercoagulability.
In parallel, we investigated platelet function testing using VerifyNow to assess aspirin responsiveness in pediatric cardiac surgery patients. Aspirin unresponsiveness was significantly associated with increased postoperative thrombosis in select cardiac populations, whereas aspirin dose escalation in nonresponsive patients correlated with a reduced risk of thrombotic events. Together, these findings support the use of VerifyNow-guided aspirin monitoring to optimize thromboprophylaxis and reduce postoperative thrombotic complications.
By combining clinical expertise with innovative research, the TEG Coagulation Laboratory is shaping the future of precision coagulation management in cardiac patient care.