title: Heparinase-modified thrombelastography in term and preterm neonates.
abstract: Thrombelastography (TEG) appears to be a promising test to assess coagulation in infants and children. TEG enables a rapid assessment of hemostatic function with only 300 microL of whole blood and provides information about plasmatic coagulation, platelet function, and fibrinolysis. In this study, we used TEG to assess the coagulation system of preterm and term neonates to determine the effects of their deficient coagulation factor levels on global hemostatic function. Heparinase-modified TEG, platelet and red blood cell count, plasma fibrinogen, and prothrombin time were assessed in four groups of clinically stable infants: severely preterm (gestational age [GA], 27-31 wk), moderately preterm (GA, 32-36 wk), term (GA, 36-40 wk), and former preterm (corrected GA, 34-40 wk). Healthy adult volunteers served as a control group. When compared with the adult group, thromboelastography revealed no defects in coagulation from groups of clinically stable infants, documenting the functional integrity of coagulation despite, in part, decreased conventional coagulation variables. Because clinically stable preterm and term infants show a relatively small incidence of bleeding, despite prolonged conventional coagulation tests, TEG may better reflect the hemostatic potential of these patients compared with conventional coagulation tests.
  
  
  CONCLUSIONS
  This study assessed the coagulation of preterm and term infants by thrombelastography and found functional integrity of coagulation despite, in part, decreased conventional coagulation variables.
authors.affiliation: *Department of Anesthesiology and General Intensive Care, University of Vienna; †Ludwig Boltzmann Institute of Clinical Anesthesiology and Intensive Care; ‡Department of Neonatology and Intensive Care, University of Vienna; and §Ludwig Boltzmann Institute of Pediatric Endocrinology and Immunology, University of Vienna, Vienna, Austria.
authors.forename: Stephan C
authors.initials: SC
authors.lastname: Kettner
authors.forename: Arnold
authors.initials: A
authors.lastname: Pollak
authors.forename: Michael
authors.initials: M
authors.lastname: Zimpfer
authors.forename: Tanja
authors.initials: T
authors.lastname: Seybold
authors.forename: Andrea R
authors.initials: AR
authors.lastname: Prusa
authors.forename: Kurt
authors.initials: K
authors.lastname: Herkner
authors.forename: Stefan
authors.initials: S
authors.lastname: Kuhle
mesh_terms: D000328:Adult; D000704:Analysis of Variance; D019763:Heparin Lyase / Q000097:blood*; D006801:Humans; D007231:Infant, Newborn; D007234:Infant, Premature / Q000378:metabolism*; D013916:Thrombelastography / Q000379:methods*
chemical_list: D019763:Heparin Lyase