{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,9,27]],"date-time":"2025-09-27T10:54:11Z","timestamp":1758970451581,"version":"3.40.5"},"reference-count":10,"publisher":"Wiley","issue":"12","license":[{"start":{"date-parts":[[2020,9,17]],"date-time":"2020-09-17T00:00:00Z","timestamp":1600300800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"funder":[{"DOI":"10.13039\/100007915","name":"Baylor College of Medicine","doi-asserted-by":"publisher","award":["Clayton Award"],"award-info":[{"award-number":["Clayton Award"]}],"id":[{"id":"10.13039\/100007915","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Transfusion"],"published-print":{"date-parts":[[2020,12]]},"abstract":"Abstract<\/jats:title>Background<\/jats:title>Neonates have lower levels of antithrombin (AT) due to immature liver synthetic function. AT deficiency may lead to inadequate anticoagulation with heparin during cardiac surgery resulting in consumption of coagulation factors and increased blood transfusion. The goal of this study is to examine the effect of AT level on the transfusion requirements of neonates and infants undergoing open heart surgery.<\/jats:p><\/jats:sec>Study Design and Methods<\/jats:title>This is a prospective, observational study at a tertiary pediatric referral center. Neonates and infants up to 6 months of age undergoing congenital heart surgery with cardiopulmonary bypass (CPB) were enrolled. Demographic, intraoperative, transfusion, and complications data were collected. Preoperative AT level was measured after induction of anesthesia. Prior to separation from CPB, a second blood sample was drawn and AT, thrombin antithrombin complex (TAT), D\u2010dimer, and anti\u2010Xa levels were measured. Linear and logistic regression were performed for data analysis.<\/jats:p><\/jats:sec>Results<\/jats:title>Preoperative low AT level was significantly associated with increased transfusion of red blood cells (RBCs) and fresh frozen plasma (FFP) during CPB, but not after separation from CPB. The incidence of thrombosis and re\u2010operation were not associated with preoperative AT levels. There was no association between TAT, D\u2010dimer, and anti\u2010Xa levels at the end of CPB and preoperative AT levels.<\/jats:p><\/jats:sec>Conclusion<\/jats:title>Low preoperative AT level is associated with increased transfusion of RBC and FFP on CPB in neonates and infants undergoing congenital heart surgery. Low preoperative AT level did not result in coagulation activation after CPB and after surgery.<\/jats:p><\/jats:sec>","DOI":"10.1111\/trf.16082","type":"journal-article","created":{"date-parts":[[2020,9,17]],"date-time":"2020-09-17T10:06:19Z","timestamp":1600337179000},"page":"2841-2848","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":3,"title":["Low antithrombin levels in neonates and infants undergoing congenital heart surgery result in more red blood cell and plasma transfusion on cardiopulmonary bypass"],"prefix":"10.1111","volume":"60","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-2890-4557","authenticated-orcid":false,"given":"Zhe Amy","family":"Fang","sequence":"first","affiliation":[{"name":"Department of Anesthesiology and Pain Medicine Hospital for Sick Children Toronto Ontario Canada"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Karen","family":"Bruzdoski","sequence":"additional","affiliation":[{"name":"Department of Pathology Texas Children\u02bcs Hospital Houston Texas USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Vadim","family":"Kostousov","sequence":"additional","affiliation":[{"name":"Department of Pathology Texas Children\u02bcs Hospital Houston Texas USA"},{"name":"Department of Pathology & Immunology Baylor College of Medicine Houston Texas USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Shiu\u2010Ki Rocky","family":"Hui","sequence":"additional","affiliation":[{"name":"Department of Pathology Texas Children\u02bcs Hospital Houston Texas USA"},{"name":"Department of Pathology & Immunology Baylor College of Medicine Houston Texas USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"David","family":"Vener","sequence":"additional","affiliation":[{"name":"Department of Anesthesiology and Pain Medicine Texas Children\u02bcs Hospital, Baylor College of Medicine Houston Texas USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Erin","family":"Gottlieb","sequence":"additional","affiliation":[{"name":"Texas Center for Pediatric and Congenital Heart Disease The University of Texas Dell Medical School\/Dell Children\u02bcs Medical Center Austin Texas USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jun","family":"Teruya","sequence":"additional","affiliation":[{"name":"Department of Pathology Texas Children\u02bcs Hospital Houston Texas USA"},{"name":"Department of Pathology & Immunology Baylor College of Medicine Houston Texas USA"},{"name":"Department of Pediatrics Baylor College of Medicine Houston Texas USA"},{"name":"Department of Medicine Baylor College of Medicine Houston Texas USA"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2020,9,17]]},"reference":[{"key":"e_1_2_7_2_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0022-5223(19)32454-7"},{"volume-title":"Kaplan\u02bcs cardiac anesthesia: For cardiac and noncardiac surgery","year":"2017","author":"Kaplan JA","key":"e_1_2_7_3_1"},{"key":"e_1_2_7_4_1","doi-asserted-by":"publisher","DOI":"10.1097\/MAT.0000000000000099"},{"key":"e_1_2_7_5_1","doi-asserted-by":"publisher","DOI":"10.1053\/j.jvca.2018.05.052"},{"key":"e_1_2_7_6_1","doi-asserted-by":"publisher","DOI":"10.1111\/aor.12642"},{"key":"e_1_2_7_7_1","doi-asserted-by":"publisher","DOI":"10.1213\/ANE.0000000000000531"},{"key":"e_1_2_7_8_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.thromres.2017.03.021"},{"key":"e_1_2_7_9_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jtcvs.2015.10.003"},{"key":"e_1_2_7_10_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(77)91429-5"},{"key":"e_1_2_7_11_1","doi-asserted-by":"publisher","DOI":"10.2165\/00003495-200767100-00005"}],"container-title":["Transfusion"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/trf.16082","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/full-xml\/10.1111\/trf.16082","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/trf.16082","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2023,9,5]],"date-time":"2023-09-05T01:22:12Z","timestamp":1693876932000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1111\/trf.16082"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2020,9,17]]},"references-count":10,"journal-issue":{"issue":"12","published-print":{"date-parts":[[2020,12]]}},"alternative-id":["10.1111\/trf.16082"],"URL":"https:\/\/doi.org\/10.1111\/trf.16082","archive":["Portico"],"relation":{},"ISSN":["0041-1132","1537-2995"],"issn-type":[{"type":"print","value":"0041-1132"},{"type":"electronic","value":"1537-2995"}],"subject":[],"published":{"date-parts":[[2020,9,17]]},"assertion":[{"value":"2020-05-25","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication 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