Thromboelastography in term neonates: an alternative approach to evaluating coagulopathy

Area of Science:

• Neonatal Medicine
• Hematology
• Clinical Pathology

Background:

• Thromboelastography (TEG) is essential for assessing hemostasis.
• Normative TEG values in term neonates are not well-established.
• Neonatal coagulation differs significantly from adults.

Purpose of the Study:

• To establish normative ranges for citrate-modified and heparinase-modified TEG parameters in term neonates.
• To identify predictive cut-off values for bleeding in this population.

Main Methods:

• Prospective observational study conducted in a neonatal and cardiac intensive care unit.
• Enrolled 30 term neonates as controls and 17 infants with bleeding requiring transfusion.
• Analyzed citrate-modified and heparinase-modified TEG parameters from blood samples.

Main Results:

• Neonatal TEG values differ from adults, with generally lower R and K values and higher LY30 and CI.
• Established median (Q1-Q3) values for R, K, α angle, MA, LY30, and CI in term neonates.
• Determined optimal cut-off points for R, K, α angle, MA, and CI to predict bleeding.

Conclusions:

• The developed reference ranges and cut-off points are valuable for diagnosing and managing coagulopathy in term neonates.
• These findings support the clinical utility of TEG in neonatal critical care settings.