PD152 - HEMOSTATIC ALTERATIONS IN SEPTIC NEONATES IN CONVENTIONAL COAGULATION TESTS AND ROTEM PARAMETERS (ID 1924)
- Dimitra Gialamprinou (Greece)
- Georgios Mitsiakos (Greece)
- Abraham Pouliakis (Greece)
- Georgios Katsaras (Greece)
- Christos-Georgios Kontovazainitis (Greece)
- Ilias Chatziioannidis (Greece)
- Athanasios Moraitis (Greece)
- Anastasia Banti (Greece)
- Alexandra Fleva (Greece)
- Emmanuel Roilides (Greece)
- Elissavet Diamanti (Greece)
Abstract
Backgrounds:
Rotational thromboelastometry (ROTEM) is well established in assessing adult sepsis associated coagulopathy. We aimed to assess coagulation during neonatal sepsis with ROTEM compared to conventional coagulation tests.
Methods:
A prospective study in septic neonates was conducted from 01/2020 to 10/2021. Conventional coagulation tests and ROTEM variables were measured.
Results:
Twenty-eight preterm hospitalized septic neonates were compared with 30 matched healthy controls. Septic neonates, on the first day had prolonged INTEM CFT and reduced a, higher FIBTEM A10, A20, A30, MCF, LI45, LI60 (Table 1). Οn the 2nd-3rd day they had higher INTEM LI60, FIBTEM A10, A20, A30, MCF, LI45, LI60. On 5th-7th day they had higher INTEM A10, A20, A30, MCF, a and reduced CFT, higher EXTEM A10, A20, A30, MCF, a and reduced CFT, and reduced FIBTEM CT, higher A10, A20, A30, MCF, a. Regarding the classical coagulation tests: on first day septic neonates had longer PT and aPTT, higher fibrinogen; on the 2nd-3rd day, they had longer aPTT, higher fibrinogen; on the 5th-7th day, they had longer aPTT. Septic neonates during sepsis had increased INTEM A10, A20, A30, MCF, a and reduced CFT, reduced EXTEM CT, CFT and increased A10, A20, A30, MCF, a, and increased FIBTEM a.
Conclusions/Learning Points:
ROTEM revealed a more hypercoagulable profile with hypofibrinolysis in septic neonates. Only INTEM in the first day present a likely hypocoagulable profile in the initiate stage of clot formation. The prolongation of PT and aPTT suggest a more hypocoaugalable profile during sepsis. Concerning the PT and aPTT lack in depicting cellular hemostasis model, the lack of institutional neonatal reference ranges, and that ROTEM interprets more effectively the coagulation in vivo, routine use of ROTEM may be considered.
