title: Prediction of neonatal sepsis by thromboelastography.
abstract: The thromboelastogram (TEG) measures functional defects in coagulation, from fibrin formation through platelet aggregation to fibrinolysis. It is comparable with standard laboratory tests of coagulation; however, it provides additional useful qualitative information. This prospective study documents the TEG findings in 103 neonates: 60 were normal and healthy and provided a reference range; 12 surgical babies had established sepsis, 15 had early sepsis, and 16 were non-septic. TEG abnormalities were detected only in those patients with early and established sepsis. Abnormalities were found in all but 1 of this group of 27 patients (96%), whereas only 16 (59%) had thrombocytopenia, 2 (6%) had leukocytosis, and 6 had leukopenia. The TEG had a sensitivity for sepsis of 96% and a specificity of 96%. This exceeds the values for routine full blood-count parameters and other laboratory indicators of sepsis. It was found to be a simple, quick, and sensitive indicator of early sepsis that enabled the clinicians to manage septic newborns earlier.
authors.affiliation: Department of Paediatric Surgery, University of Natal, P. O. Box 17039, Congella 4013, Natal, South Africa.
authors.forename: H W
authors.initials: HW
authors.lastname: Grant
authors.forename: G P
authors.initials: GP
authors.lastname: Hadley
mesh_terms: D001772:Blood Cell Count; D016022:Case-Control Studies; D006801:Humans; D007231:Infant, Newborn; D011237:Predictive Value of Tests; D011446:Prospective Studies; D012680:Sensitivity and Specificity; D018805:Sepsis / Q000097:blood* / Q000175:diagnosis / Q000453:epidemiology; D013916:Thrombelastography