Hemostatic phenotypes assessed by ROTEM in term neonates with sepsis
Main Article Content
Abstract
Hemostatic disturbances are common in neonatal sepsis and exhibit diverse phenotypes. A cross-sectional descriptive study was conducted on 168 term neonates with sepsis admitted to the National Children’s Hospital between June 2024 and December 2025. Rotational thromboelastometry (ROTEM) was used to characterize coagulation and fibrinolytic phenotypes. Compared with the non-shock group, neonates with septic shock had significantly higher rates of hypocoagulability (84.4% vs. 47.4%; p < 0.001) and hypofibrinolysis (31.1% vs. 12.8%; p = 0.003). Among patients with septic shock, the incidence of thrombosis was significantly higher in those with hypofibrinolysis than in those without hypofibrinolysis (17.9% vs. 3.2%; p = 0.028), whereas no significant difference in bleeding rates was observed between hypocoagulable and non-hypocoagulable patients. Hemostatic dysfunction in neonatal septic shock is characterized not only by impaired clot formation but also by suppressed fibrinolysis and a prothrombotic tendency. ROTEM enables a comprehensive assessment of these distinct coagulation and fibrinolytic phenotypes.
Article Details
Keywords
Septic shock, term neonates, rotational thromboelastometry (ROTEM), coagulopathy, hypofibrinolysis
References
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