title: Reference ranges of thromboelastometry in healthy full-term and pre-term neonates.
abstract: BACKGROUND
  Rotational thromboelastometry (ROTEM) is an attractive method for rapid evaluation of hemostasis in neonates. Currently, no reference values exist for ROTEM assays in full-term and pre-term neonates. Our aim was to establish reference ranges for standard extrinsically activated ROTEM assay (EXTEM) in arterial blood samples of healthy full-term and pre-term neonates.
  
  
  METHODS
  In the present study, EXTEM assay was performed in 198 full-term (≥37 weeks' gestation) and 84 pre-term infants (<37 weeks' gestation) using peripheral arterial whole blood samples.
  
  
  RESULTS
  Median values and reference ranges (2.5th and 97.5th percentiles) for the following main parameters of EXTEM assay were determined in full-term infants: clotting time (seconds), 41 (range, 25.9-78); clot formation time (seconds), 70 (range, 40-165.2); maximum clot firmness (mm), 66 (range, 41-84.1); lysis index at 60 min (LI60, %), 97 (range, 85-100). The only parameter with a statistically significant difference between full-term and pre-term neonates was LI60 (p=0.006). Furthermore, it was inversely correlated with gestational age (p=0.002) and birth weight (p=0.016) in pre-term neonates.
  
  
  CONCLUSIONS
  In conclusion, an enhanced fibrinolytic activity in pre-term neonates was noted. For most EXTEM assay parameters, reference ranges obtained from arterial newborn blood samples were comparable with the respective values from studies using cord blood. Modified reagents, small size samples, timing of sampling, and different kind of samples might account for any discrepancies among similar studies. Reference values hereby provided can be used in future studies.
authors.affiliation: .
authors.forename: Rozeta
authors.initials: R
authors.lastname: Sokou
authors.affiliation: .
authors.forename: Leontini
authors.initials: L
authors.lastname: Foudoulaki-Paparizos
authors.affiliation: .
authors.forename: Theodore
authors.initials: T
authors.lastname: Lytras
authors.affiliation: .
authors.forename: Aikaterini
authors.initials: A
authors.lastname: Konstantinidi
authors.affiliation: .
authors.forename: Martha
authors.initials: M
authors.lastname: Theodoraki
authors.affiliation: .
authors.forename: Ioannis
authors.initials: I
authors.lastname: Lambadaridis
authors.affiliation: .
authors.forename: Antonis
authors.initials: A
authors.lastname: Gounaris
authors.affiliation: .
authors.forename: Serena
authors.initials: S
authors.lastname: Valsami
authors.affiliation: .
authors.forename: Marianna
authors.initials: M
authors.lastname: Politou
authors.affiliation: .
authors.forename: Argyri
authors.initials: A
authors.lastname: Gialeraki
authors.affiliation: .
authors.forename: Georgios K
authors.initials: GK
authors.lastname: Nikolopoulos
authors.affiliation: .
authors.forename: Nicoletta
authors.initials: N
authors.lastname: Iacovidou
authors.affiliation: .
authors.forename: Stefanos
authors.initials: S
authors.lastname: Bonovas
authors.affiliation: .
authors.forename: Argirios E
authors.initials: AE
authors.lastname: Tsantes
mesh_terms: D001724:Birth Weight; D005260:Female; D005865:Gestational Age; D006801:Humans; D007231:Infant, Newborn; D007234:Infant, Premature; D008297:Male; D011446:Prospective Studies; D012016:Reference Values; D012737:Sex Factors; D013916:Thrombelastography / Q000592:standards*
keywords: neonates; reference ranges; thromboelastometry