Hamostaseologie 2016; 36(04): 261-264
DOI: 10.5482/HAMO-15-11-0032
Review
Schattauer GmbH

Neonatal haemostasis

Impact on bleeding and thrombosisNeonatale HämostaseEinfluss auf Blutung und Thrombose
Shoshana Revel-Vilk
1   Hadassah- Hebrew University Medical Center, Jerusalem, Israel
› Author Affiliations
Further Information

Publication History

Received 20 November 2015

Accepted in revised form: 14 January 2016

Publication Date:
18 December 2017 (online)

Summary

The maturation and postnatal development of the human coagulation system results in significant and important differences in the coagulation and fibrinolysis of neonates and young children compared to older children and adults. Importantly, these differences, which mostly reflect the immaturity of the neonatal haemostasis system, are functionally balanced. Healthy neonates show no signs of easy bruising or other bleeding diathesis and no increased tendency to thrombosis for any given stimulus compared to adults.

Systemic diseases may affect haemostasis, thus predisposing ill neonates to increased risk for haemorrhagic or thrombotic complications. In hospitalized children, neonates have increased risk of developing thrombosis compared to infants and children, mostly associated with the presence of central venous catheter. For diagnosis of haemostasis disorders, diagnostic laboratories processing pediatric samples should use age, analyzer and reagent appropriate reference ranges. Age specific guidelines should be followed for the management of neonates with hemostatic disorders.

Zusammenfassung

Durch die Reifung und postnatale Entwick-lung des menschlichen Gerinnungssystems weisen Blutgerinnung und Fibrinolyse bei Neugeborenen und Kleinkindern wesentliche Unterschiede gegenüber älteren Kindern und Erwachsenen auf. Entscheidend ist, dass diese Unterschiede, meist Ausdruck der Unreife des neonatalen Hämostasesystems, funktional ausgeglichen sind. Gesunde Neugeborene zeigen im Vergleich zu Erwachsenen weder Neigung zu Hämatombildung oder anderen hämorrhagischen Diathesen noch eine verstärkte Thrombosetendenz jedweder Ursache.

Systemische Krankheiten können sich auf die Hämostase auswirken und so das Risiko für hämorrhagische oder thrombotische Komplikationen bei kranken Neugeborenen erhöhen. Neugeborene haben unter hospitalisierten Kindern ein höheres Risiko, Thrombosen zu entwickeln als Säuglinge und Kinder, meist in Zusammenhang mit einem zentralen Venenkatheter. Bei der Diagnose von Gerinnungsstörungen sollten diagnostische Labore, die pädiatrische Proben verarbeiten, Referenzwerte anwenden, die für das Alter, Analysegerät und Reagenz geeignet sind. Es sollten die altersspezifischen Richtlinien für die Behandlung von Neugeborenen mit Gerinnungsstörungen befolgt werden.

 
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