TY - JOUR
TI - The use of thromboelastography (TEG) and rotational thromboelastometry
(ROTEM) in neonates: a systematic review
AU - Katsaras, Georgios N.
AU - Sokou, Rozeta
AU - Tsantes, Andreas G. and
AU - Piovani, Daniele
AU - Bonovas, Stefanos
AU - Konstantinidi, Aikaterini and
AU - Ioakeimidis, Georgios
AU - Parastatidou, Stauroula
AU - Gialamprinou,
AU - Dimitra
AU - Makrogianni, Athanasia
AU - Mitsiakos, Georgios
AU - Tsantes,
AU - Argirios E.
JO - European Journal of Pediatrics
PY - 2021
VL - 180
TODO - 12
SP - 3455-3470
PB - Springer-Verlag
SN - 0340-6199, 1432-1076
TODO - 10.1007/s00431-021-04154-4
TODO - Blood coagulation tests; Hemorrhage; Hemostasis; Infant,Newborn;
Thromboelastography
TODO - “Developmental hemostasis” refers to the dynamic process of gradual
hemostatic maturation. Conventional coagulation tests seem to fail to
accurately depict the in vivo hemostasis, while viscoelastic tests,
thromboelastography (TEG), and rotational thromboelastometry (ROTEM)
appear very promising as they provide insight more rapidly and
accurately into the hemostatic potential. We systematically reviewed the
literature in PubMed to examine the use of TEG and ROTEM in neonates.
Our search yielded 34 studies, of which 18 concerned healthy neonates
and 16 sick neonates. These viscoelastic tests have shown accelerated
initiation of coagulation, increased clot strength, and increased
fibrinolysis in healthy neonates compared to children and adults. Cord
blood leads to a hypercoagulable state as compared to whole blood when
testing is performed with TEG. Pre-term neonates have a more
hypocoagulable profile, but balanced hemostasis, related to term
neonates, that evolves to a more procoagulant phenotype over the first
month of life. Critically ill neonates exhibit a more hypocoagulable
profile as compared to healthy neonates. TEG and ROTEM have shown
predictive value for bleeding events in critically ill neonates and
neonates undergoing cardiopulmonary bypass or therapeutic hypothermia.
Conclusion: TEG and ROTEM need to become part of the standard
coagulation assessment in clinical settings in which hemostatic
abnormalities are involved, as they seem to provide more rapid and
accurate information regarding the hemostatic profile of the neonates.
Their predictive value for bleeding events in critically ill neonates
could lead to a more targeted therapy optimizing utilization of blood
products.
ER -