Reference Values of Thrombolastometry Parameters in Healthy Term Neonates

Area of Science:

• Neonatal hemostasis
• Point-of-care testing
• Clinical diagnostics

Background:

• Rotational thromboelastometry (ROTEM) is a valuable point-of-care test for rapid hemostasis evaluation.
• Lack of established reference ranges for ROTEM assays in neonates hinders its clinical application.
• This study addresses the need for neonatal-specific ROTEM reference values.

Purpose of the Study:

• To establish reference ranges for EXTEM, INTEM, and FIBTEM ROTEM assays in healthy term neonates.
• To investigate the influence of gender, delivery mode, and hematocrit on ROTEM parameters.
• To enhance the diagnostic utility of ROTEM in neonatal care.

Main Methods:

• Simultaneous performance of EXTEM, INTEM, and FIBTEM ROTEM assays with complete blood count.
• Analysis of whole blood samples from 215 healthy term neonates.
• Determination of 2.5th and 97.5th percentiles for key ROTEM parameters.

Main Results:

• Established reference ranges for ROTEM parameters including CT, CFT, A10, MCF, and LI60 for EXTEM, INTEM, and FIBTEM assays.
• Identified significant correlations between hematocrit and ROTEM parameters (CT, CFT, A10, MCF).
• Provided comprehensive data for neonatal ROTEM interpretation.

Conclusions:

• This study presents the first simultaneous reference ranges for ROTEM EXTEM/INTEM/FIBTEM in healthy term neonates.
• The combined evaluation of ROTEM tests improves diagnostic accuracy.
• Expansion of ROTEM utilization in the neonatal population is supported by these findings.