Contemporary tools for evaluation of hemostasis in neonates. Where are we and where are we headed?

Sokou, Rozeta; Parastatidou, Stavroula; Konstantinidi, Aikaterini; Tsantes, Andreas G.; Iacovidou, Nicoletta; Piovani, Daniele; Bonovas, Stefanos; Tsantes, Argirios E.

doi:10.1016/j.blre.2023.101157

Cited by 1 publication

(1 citation statement)

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“…However, taking into consideration both the laboratory data and clinical manifestations, we tend to conclude that a prothrombotic tendency is more dominant in our patient group. Nonetheless, conventional coagulation assays are not designed to evaluate the global hemostatic mechanism [71]. Future studies on newer viscoelastic techniques in neonates with CHD at an initial stable disease state would be of interest and give a thorough insight into the hemostatic status of these patients.…”

Section: Discussionmentioning

confidence: 99%

Coagulation Profile in Neonates with Congenital Heart Disease: A Pilot Study

Papadogeorgou,

Valsami,

Boutsikou

et al. 2024

Medicina

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Background and Objectives: congenital heart disease (CHD), cyanotic and, to a lesser degree, acyanotic, often are accompanied by coagulation abnormalities, impacting substantially morbidity and mortality. Until now, no consistent hemostatic patterns have been demonstrated in neonates and children with CHD because they represent a variable and heterogenous population. The aim of the present study is to investigate the hemostatic profile, as well as the role of ADAMTS-13 (a disintegrin and metalloprotease with thrombospondin type-1 motives), the cleaving protein of von Willebrand factor (VWF) in neonates with CHD and compare them to healthy age-matched controls. Materials and Methods: twenty neonates with a mean gestational age of 37.1 ± 2.5 weeks were included in the CHD group, and 18 healthy neonates with a mean gestational age of 38.2 ± 1.5 weeks were in the control group. Results: prothrombin time was significantly prolonged, and accordingly, factor VII (FVII) levels were significantly decreased in the CHD group in comparison to controls. Factor VIII (FVIII), VWF, and ristocetin cofactor activity (Rcof) levels were significantly higher in the study vs. control group. Concentrations of ADAMTS-13 were decreased in the CHD vs. control group, but the difference was not statistically significant. Our results, in combination, indicate a balanced hemostatic mechanism, although with greater variability in neonates with CHD, while developmental aspects of coagulation are evident in the specific patient population. Conclusions: the coagulation profile is moderately impaired early in the course of CHD, though increased thrombogenicity is already present and should not be ignored.

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Section: Discussionmentioning

confidence: 99%