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lity or gastric distention. It is effective for pediatric patients with non-cyanotic congenital heart disease who require procedural sedation. The shortage of blood products has become a worldwide problem, especially during the COVID-19 Pandemic. Here, we investigated whether a point of care (POC) approach to perioperative bleeding and coagulopathy based on rotational thromboelastometry (ROTEM) results could decrease perioperative blood loss and the perioperative consumption of blood products during lung transplantation. Patients undergoing bilateral lung t