Neonatal Coagulation Profile and Vitamin K Administration

Clinical Indications for Coagulation Studies

The American Academy of Chest Physicians recommends that coagulation studies be ordered in neonates with clinical presentation suggesting homozygous protein C deficiency, such as purpura fulminans or extensive thrombosis, with a Grade 1A recommendation 1
In cases of suspected homozygous protein C deficiency, administration of FFP 10-20 mL/kg every 12 hours or protein C concentrate 20-60 units/kg is recommended until clinical lesions resolve, with a Grade 1A recommendation 1
For neonates with severe bleeding or in shock, the administration of fresh frozen plasma (FFP) 10-20 mL/kg is recommended to provide immediate clotting factors while waiting for vitamin K to take effect, according to Praxis Medical Insights 2

The American Academy of Chest Physicians recommends that homozygous protein C deficiency be treated with long-term options including vitamin K antagonists, LMWH, protein C replacement, or liver transplantation 1