Abstract
The thromboelastogram (TEG) measures functional defects in coagulation, from fibrin formation through platelet aggregation to fibrinolysis. It is comparable with standard laboratory tests of coagulation; however, it provides additional useful qualitative information. This prospective study documents the TEG findings in 103 neonates: 60 were normal and healthy and provided a reference range; 12 surgical babies had established sepsis, 15 had early sepsis, and 16 were non-septic. TEG abnormalities were detected only in those patients with early and established sepsis. Abnormalities were found in all but 1 of this group of 27 patients (96%), whereas only 16 (59%) had thrombocytopenia, 2 (6%) had leukocytosis, and 6 had leukopenia. The TEG had a sensitivity for sepsis of 96% and a specificity of 96%. This exceeds the values for routine full blood-count parameters and other laboratory indicators of sepsis. It was found to be a simple, quick, and sensitive indicator of early sepsis that enabled the clinicians to manage septic newborns earlier.
This is a preview of subscription content, log in via an institution to check access.
Similar content being viewed by others
References
Bone RC (1992) Modulators of coagulation: a critical appraisal of their role in sepsis. Arch Intern Med 152: 1381–1389
Boyle RJ, Chandler BD, Stonestreet B, Oh W (1978) Early identification of sepsis in infants with respiratory distress. Pediatrics 62: 744–750
Colman RW Robboy SJ, Minna JD (1972) Disseminated intravascular coagulation (DIC): an approach. Am J Med 52: 679–684
Corrigan JJ (1974) Thrombocytopenia: a laboratory sign of septicaemia in infants and children. J Pediatr 85: 219–221
Gedde-Dahl TW, Bjark P, Høiby EA, Host JH, Brunn JN (1990) Severity of meningococcal disease: assessment by factors and scores and implications for patient management. Rev Infect Dis. 12: 973–991
Guillois B, Donnou MD, Sizun J, Bendouad B et al (1994) Comparative study of four tests of bacterial infection in the neonate. Biol Neonate 66: 175–181
Heyderman RS (1993) Sepsis and intravascular thrombosis. Arch Dis Child 68: 621–625
Howland WS, Schweizer O, Gould P (1974) A comparison of intraoperative measurements of coagulation. Anesth Analg 53: 657–663
Kang YG, Martin DJ, Marquez J, Lewis JH et al (1985) Intraoperative changes in blood coagulation and thrombelastographic monitoring in liver transplantation. Anesth Analg 64: 888–896
Kang Y, Martin LK, Marquez J, Lewis JH (1989) Thromboelastographic monitoring of coagulation during cardiac surgery. Anesthesiology 71: A8
Levin M (1990) The inflammatory response to infections. In: de Louvois J, Harvey D (eds) Infection in the newborn. Wiley & Sons, New York, pp 1–12
Mallett SV, Cox DJA (1992) Thrombelastography. Br J Anaesthe 69: 307–313
Martin P, Horkay F, Rajah S, Walker DR (1991) Monitoring of coagulation status using thrombo-elastography during paediatric open heart surgery. Int J Clin Monit Comput 8: 183–187
Saez-Llorens X, McCracken GH (1993) Sepsis syndrome and septic shock in paediatrics: current concepts of terminology, pathophysiology, and management. J Pediatr 123: 497–508
Squire E, Favara B, Todd J (1979) Diagnosis of neonatal bacterial infection: hematologic and pathologic findings in fatal and nonfatal cases. Pediatrics 64: 60–64
Zuckerman L, Cohen E, Vagher JP, Woodward W, Caprini JA (1981) Comparison of thrombelastography with common coagulation tests. Thromb Haemostas 46: 752–756
Author information
Authors and Affiliations
Rights and permissions
About this article
Cite this article
Grant, H.W., Hadley, G.P. Prediction of neonatal sepsis by thromboelastography. Pediatr Surg Int 12, 289–292 (1997). https://doi.org/10.1007/BF01372152
Accepted:
Issue Date:
DOI: https://doi.org/10.1007/BF01372152