title: Thromboelastographic profiles of the premature infants with and without intracranial hemorrhage at birth: a pilot study.
abstract: OBJECTIVE
  To delineate thromboelastographic profiles of the premature infants with and without intracranial hemorrhage during the first 21 days of life.
  
  
  METHODS
  In this study, 49 premature infants (24 female; 25 male) were consecutively admitted at our neonatal intensive care unit during a 6 months period were subject to thromboelastography and standard coagulation assessments at birth and weekly up to 21 days. Sixteen out of 49 infants developed intracranial hemorrhage at birth.
  
  
  RESULTS
  The test results of 127/196 were considered eligible for analysis. Overall significant changes of the main thromboelastographic parameters were observed shortly after birth. Newborns with intracranial hemorrhage showed increased thromboelastogram-defined thrombin generation (shorter R and time to maximum amplitude times) from birth onward, suggesting a hypercoagulable state. No significant differences concerning thromboelastographic and coagulation assays parameters were found at birth between infants with and without intracranial hemorrhage, except for higher plasma D-Dimer concentration (p = 0.002) in the former infants. Finally, a positive correlation between clot lysis time and gestational age (Spearman's rho = 0.502, p = 0.002) was observed.
  
  
  CONCLUSIONS
  Thromboelastographic profiles of the premature infants suggest an effective hemostatic function during the first post-natal weeks. Further study is needed to determine whether thromboelastography may be more useful than coagulation assays to reflect the bleeding risk of the premature infants.
authors.affiliation: a Neonatal Intensive Care Unit, S. Maria della Misericordia Hospital of Perugia , Perugia , Italy .
authors.forename: Maurizio
authors.initials: M
authors.lastname: Radicioni
authors.forename: Alessia
authors.initials: A
authors.lastname: Bruni
authors.forename: Vittorio
authors.initials: V
authors.lastname: Bini
authors.forename: Alfredo
authors.initials: A
authors.lastname: Villa
authors.forename: Carla
authors.initials: C
authors.lastname: Ferri
mesh_terms: D005260:Female; D005338:Fibrin Fibrinogen Degradation Products / Q000032:analysis; D005865:Gestational Age; D006801:Humans; D007231:Infant, Newborn; D007234:Infant, Premature / Q000502:physiology; D007235:Infant, Premature, Diseases / Q000175:diagnosis* / Q000503:physiopathology; D007363:Intensive Care Units, Neonatal; D020300:Intracranial Hemorrhages / Q000151:congenital / Q000175:diagnosis* / Q000503:physiopathology; D008297:Male; D008991:Monitoring, Physiologic / Q000379:methods*; D015997:Neonatal Screening / Q000379:methods; D036801:Parturition; D010865:Pilot Projects; D013916:Thrombelastography
chemical_list: D005338:Fibrin Fibrinogen Degradation Products; C036309:fibrin fragment D
keywords: Coagulation assays; intraventricular hemorrhage neonate; neonatal hemostasis; thromboelastography; thromboelastometry