The expression "developmental hemostasis" indicates the age-related physiological changes occurring during the maturational process of the hemostatic system. Despite the quantitative and qualitative alterations, the neonatal hemostatic system is competent and well-balanced. Conventional coagulation tests do not provide reliable information as they only explore the procoagulants during the neonatal period. In contrast, viscoelastic coagulation tests (VCTs), such as viscoelastic coagulation monitoring (VCM), thromboelastography (TEG or ClotPro), and rotational thromboelastometry (ROTEM), are point-of-care assays that provide a quick, dynamic and global view of the hemostatic process, allowing prompt and individualized therapeutic intervention when necessary. Their use in neonatal care is on the increase and they could help monitor patients at risk of hemostatic derangement. In addition, they are crucial for anticoagulation monitoring during extracorporeal membrane oxygenation. Moreover, implementing VCT-based monitoring could optimize blood product use.

Viscoelastic coagulation testing in Neonatal Intensive Care Units: advantages and pitfalls in clinical practice / F. Manzoni, G. Raffaeli, V. Cortesi, G.S. Amelio, I. Amodeo, S. Gulden, G. Cervellini, A. Tomaselli, M. Colombo, A. Artoni, S. Ghirardello, F. Mosca, G. Cavallaro. - In: BLOOD TRANSFUSION. - ISSN 2385-2070. - (2023), pp. 1-11. [Epub ahead of print] [10.2450/2023.0203-22]

Viscoelastic coagulation testing in Neonatal Intensive Care Units: advantages and pitfalls in clinical practice

F. Manzoni
Co-primo
;
G. Raffaeli
Co-primo
;
V. Cortesi;G. Cervellini;A. Tomaselli;M. Colombo;F. Mosca
Penultimo
;
2023

Abstract

The expression "developmental hemostasis" indicates the age-related physiological changes occurring during the maturational process of the hemostatic system. Despite the quantitative and qualitative alterations, the neonatal hemostatic system is competent and well-balanced. Conventional coagulation tests do not provide reliable information as they only explore the procoagulants during the neonatal period. In contrast, viscoelastic coagulation tests (VCTs), such as viscoelastic coagulation monitoring (VCM), thromboelastography (TEG or ClotPro), and rotational thromboelastometry (ROTEM), are point-of-care assays that provide a quick, dynamic and global view of the hemostatic process, allowing prompt and individualized therapeutic intervention when necessary. Their use in neonatal care is on the increase and they could help monitor patients at risk of hemostatic derangement. In addition, they are crucial for anticoagulation monitoring during extracorporeal membrane oxygenation. Moreover, implementing VCT-based monitoring could optimize blood product use.
neonatal; developmental hemostasis; viscoelastic test; point-of-care tests
Settore MED/38 - Pediatria Generale e Specialistica
2023
13-gen-2023
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Utilizza questo identificativo per citare o creare un link a questo documento: https://hdl.handle.net/2434/961151
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