Hemostasis Assessment in Neonates: Evaluation of Viscoelastic Properties of Blood Clots
Brunetta Guaragni, Mario Motta
Keywords :
Activated partial prothrombin time, Developmental hemostasis, Fibrinogen levels, Fibrinolytic activity, Natural anticoagulants, Platelet function, Procoagulant factors, Prothrombin time, Viscoelastic coagulation tests, von Willebrand factor
Citation Information :
Guaragni B, Motta M. Hemostasis Assessment in Neonates: Evaluation of Viscoelastic Properties of Blood Clots. 2024; 3 (1):38-44.
In recent years, a new approach to neonatal hemostasis has been taking hold. The term “developmental hemostasis” refers to the dynamic, age-related physiological changes seen in the hemostatic system in neonates and young infants. Most conventional coagulation tests have limitations as these are focused primarily on the procoagulant factors and do not inform about platelet function and the levels/activity of von Willebrand factor (vWF), natural anticoagulants, and fibrinolytic activity. In this scheme, viscoelastic coagulation tests can rapidly provide a potentially useful, panoramic assessment of the entire coagulation process from the formation to degradation of clots, platelet function, and fibrinolysis. This is a narrative review on the use of viscoelastic tests in neonatal care; we have included information from our own clinical experience and from an extensive literature search spanning PubMed, Scopus, and Web of Science. This review is important because tests can help identify premature/critically ill infants who may be at risk of hemorrhage during routine care or after surgery and may need corrective transfusions with appropriate blood products.
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