Thromboelastometry in Neonates with Respiratory Distress Syndrome: A Pilot Study

Area of Science:

• Neonatal Medicine
• Hematology
• Critical Care

Background:

• Respiratory distress syndrome (RDS) is a known postnatal risk factor for bleeding and thromboembolic events in neonates.
• Limited research has explored the hemostatic profiles of neonates experiencing RDS.

Purpose of the Study:

• To evaluate the hemostatic profile of neonates with RDS.
• To utilize rotational thromboelastometry (ROTEM) for assessing coagulation in this population.

Main Methods:

• An observational study was conducted in a NICU from November 2018 to November 2020.
• Included preterm and term neonates with RDS.
• Performed EXTEM, INTEM, and FIBTEM ROTEM assays at disease onset.

Main Results:

• Neonates with RDS showed a hypocoagulable profile compared to controls.
• Significant alterations in ROTEM variables (prolonged clotting times, reduced clot firmness and lysis index) were observed.
• RDS was identified as an independent factor for these hemostatic changes.

Conclusions:

• Respiratory distress syndrome is associated with a hypocoagulable hemostatic profile in neonates.
• Neonates with RDS demonstrate a greater potential for hyperfibrinolysis compared to healthy infants.