Thromboelastometry in Neonates with Respiratory Distress Syndrome: A Pilot Study
Georgios N. Katsaras,
Rozeta Sokou,
Andreas G. Tsantes,
Aikaterini Konstantinidi,
Dimitra Gialamprinou,
Daniele Piovani,
Stefanos Bonovas,
Anastasios G. Kriebardis,
Georgios Mitsiakos,
Styliani Kokoris,
Argirios E. Tsantes
Affiliations
Georgios N. Katsaras
Neonatal Intensive Care Unit, Nikaia General Hospital “Aghios Panteleimon”, Nikaia, 18454 Piraeus, Greece
Rozeta Sokou
Neonatal Intensive Care Unit, Nikaia General Hospital “Aghios Panteleimon”, Nikaia, 18454 Piraeus, Greece
Andreas G. Tsantes
Laboratory of Haematology and Blood Bank Unit, Attikon University Hospital, School of Medicine, National and Kapodistrian University of Athens, Haidari, 12462 Athens, Greece
Aikaterini Konstantinidi
Neonatal Intensive Care Unit, Nikaia General Hospital “Aghios Panteleimon”, Nikaia, 18454 Piraeus, Greece
Dimitra Gialamprinou
Second Department of Neonatology and Neonatal Intensive Care Unit, Papageorgiou General Hospital, School of Medicine, Aristotle University of Thessaloniki, Nea Efkarpia, 56403 Thessaloniki, Greece
Daniele Piovani
Department of Biomedical Sciences, Humanitas University, Via Rita Levi Montalcini 4, Pieve Emanuele, 20090 Milan, Italy
Stefanos Bonovas
Department of Biomedical Sciences, Humanitas University, Via Rita Levi Montalcini 4, Pieve Emanuele, 20090 Milan, Italy
Anastasios G. Kriebardis
Laboratory of Reliability and Quality Control in Laboratory Hematology, Department of Biomedical Science, School of Health and Caring Science, University of West Attica, Egaleo, 12243 Athens, Greece
Georgios Mitsiakos
Second Department of Neonatology and Neonatal Intensive Care Unit, Papageorgiou General Hospital, School of Medicine, Aristotle University of Thessaloniki, Nea Efkarpia, 56403 Thessaloniki, Greece
Styliani Kokoris
Laboratory of Haematology and Blood Bank Unit, Attikon University Hospital, School of Medicine, National and Kapodistrian University of Athens, Haidari, 12462 Athens, Greece
Argirios E. Tsantes
Laboratory of Haematology and Blood Bank Unit, Attikon University Hospital, School of Medicine, National and Kapodistrian University of Athens, Haidari, 12462 Athens, Greece
Background: Although respiratory distress syndrome (RDS) constitutes a postnatal risk factor for bleeding and thromboembolic events in neonates, few studies have addressed this issue. We aimed to evaluate the hemostatic profile of neonates with RDS using rotational thromboelastometry (ROTEM). Methods: An observational study was conducted from November 2018 to November 2020 in the NICU of General Hospital of Nikaia “Aghios Panteleimon”. Preterm and term neonates with RDS hospitalized in the NICU were included and EXTEM (tissue factor-triggered extrinsic pathway), INTEM (ellagic acid activated intrinsic pathway), and FIBTEM (with platelet inhibitor cytochalasin D) assays were performed at the onset of the disease. Results: A hypocoagulable profile was noted in neonates with RDS compared to controls, expressed as significant prolongation of EXTEM CT (clotting time) and CFT (clot formation time), lower EXTEM A10 (amplitude at 10 min), MCF (maximum clot firmness), and LI60 (lysis index). Furthermore, prolongation of INTEM CFT and FIBTEM CT, and decreased INTEM and FIBTEM A10 and MCF were found in neonates with RDS. Multivariable logistic regression analysis showed that RDS is an independent factor for the recorded alterations in ROTEM variables. Conclusions: RDS is associated with a hypocoagulable profile and greater hyperfibrinolytic potential compared to healthy neonates.
