Establishing a reference range for thromboelastograph parameters in the neonatal period

Abstract

IntroductionAcquired coagulation disorders are a common cause of neonatal bleeding. The thromboelastograph (TEG) comprehensively assesses haemostatic processes in the body. Unfortunately, the reference range of TEG parameters in the neonatal period has not yet been evaluated, which limits the use of the TEG in neonates. In this study, we aimed to establish the reference range of TEG parameters for the neonatal period.MethodsThis study included 371 full‐term infants (≥37 weeks of gestation), and we divided these infants into three groups according to age as follows: 1, 2‐7 and 8‐28 days. We measured their peripheral blood using TEG, coagulation routine and platelet count tests. We analysed differences among the groups.ResultsThe reference ranges for TEG parameters are presented as medians and reference ranges (2.5th and 97.5th percentiles) as follows: R (clot reaction time, seconds) 4.80 (2.80‐7.17), Angle (fibrin production rate) 69.90 (44.91‐78.89), K (clot kinetics, min) 1.40 (0.80‐4.50), MA (maximum amplitude, mm) 63.50(44.34‐74.66) and LY30 (lysis at 30 minutes, %) 0.10 (0.10‐6.95). There were significant differences in Angle, K, MA and LY30 values between the different neonatal day age groups.ConclusionThis study preliminarily establishes a reference range for TEG parameters during the neonatal period. The age of a newborn had a large influence on TEG parameters. Additionally, we demonstrated a correlation between laboratory tests and TEG parameters for this age period. The reference values provided herein are meaningful for future studies.

Capillary blood reference intervals for platelet parameters in healthy full-term neonates in China

“…And in clinical practice, we should take neonatal sampling sites into consideration when choosing RIs for platelet parameters. A recent study showed that neonatal age had a significant effect on the parameters regarding coagulation [28]. And we found a slight variation in PLT in the first days of life.…”

Capillary blood reference intervals for platelet parameters in healthy full-term neonates in China

“…A recent study showed that neonatal age had a signi cant effect on the parameters regarding coagulation. [32] And we found a slight uctuation in PLT in the rst days of life. Of note, a multicentre study recruiting a large neonate cohort [4] reported that PLT values changes with two peak sinusoids at 2-3 weeks and 6-7 weeks of postnatal age.…”

Viscoelastic testing in pediatric patients

“…In fact, the rationalization and reduction of (unnecessary) blood product transfusion is one of the most important advantages of VET-based pediatric bleeding management strategies. [8][9][10] Reference values for pediatric patients have been evaluated for ROTEM, [11][12][13] TEG, [14][15][16][17][18][19][20] and the Sonoclot system. 21 The main difference for VET reference ranges between children and adults are displayed in Table 1.…”

“…22 However, it needs to be mentioned that the definition of age groups was not uniformly applied within the cited papers. While in the study of Liu et al 19 data from three neonatal age groups (1 day, 2-7 days, 8-28 days) were analyzed separately, Oswald and colleagues 11 have pooled data of children from 1 day to 3 months of age, together labeled as the youngest age group. As such, comparison of data and subsequent interpretation should be done carefully.…”