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Summary

Neonatal hemostasis is complex and challenging to measure. This review examines routine and viscoelastic tests for evaluating newborn coagulation, highlighting age-specific ranges and preanalytical errors like hematocrit.

Keywords:
bleeding disorderscoagulation testsdevelopmental hemostasishemostasisnewbornviscoelastic tests

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Area of Science:

  • Neonatal Medicine
  • Hematology
  • Clinical Pathology

Background:

  • The neonatal hemostatic system is dynamic and immature, making accurate assessment difficult.
  • Routine coagulation tests have limitations in evaluating newborn hemostasis.
  • Preanalytical variables, especially hematocrit, can significantly impact test results.

Purpose of the Study:

  • To review current knowledge on "developmental hemostasis" in newborns.
  • To evaluate the performance of routine and viscoelastic coagulation tests in neonates.
  • To discuss the establishment of neonatal age-specific normal ranges and the impact of preanalytical factors.

Main Methods:

  • Narrative review of existing literature on neonatal hemostasis.
  • Analysis of the utility and limitations of conventional coagulation assays.
  • Evaluation of viscoelastic hemostasis assays (e.g., thromboelastography) in the neonatal population.

Main Results:

  • Accurate measurement of neonatal hemostatic potential is challenging due to developmental dynamism.
  • Routine coagulation tests require age-specific normal ranges and careful consideration of preanalytical variables like hematocrit.
  • Viscoelastic tests offer rapid functional assessment but lack standardization for neonatal use.

Conclusions:

  • Understanding "developmental hemostasis" is crucial for accurate neonatal coagulation assessment.
  • Optimizing test interpretation requires addressing age-specific ranges and preanalytical interferences.
  • Further standardization of viscoelastic tests is needed to enhance their clinical utility in neonates.