Coagulation indices in very preterm infants from cord blood and postnatal samples

IF 5 2区 医学 Q1 HEMATOLOGY
E. Neary, N. McCallion, B. Kevane, M. Cotter, K. Egan, I. Regan, C. Kirkham, C. Mooney, S. Coulter-Smith, F. Ní Áinle
{"title":"Coagulation indices in very preterm infants from cord blood and postnatal samples","authors":"E. Neary,&nbsp;N. McCallion,&nbsp;B. Kevane,&nbsp;M. Cotter,&nbsp;K. Egan,&nbsp;I. Regan,&nbsp;C. Kirkham,&nbsp;C. Mooney,&nbsp;S. Coulter-Smith,&nbsp;F. Ní Áinle","doi":"10.1111/jth.13130","DOIUrl":null,"url":null,"abstract":"<div>\n \n \n <section>\n \n <h3> Background</h3>\n \n <p>Very premature infants are at high risk of bleeding complications; however, few data exist on ranges for standard coagulation tests.</p>\n </section>\n \n <section>\n \n <h3> Objectives</h3>\n \n <p>The primary objective of this study was to measure standard plasma coagulation tests and thrombin generation in very premature infants compared with term infants. The secondary objective was to evaluate whether an association existed between coagulation indices and intraventricular hemorrhage (IVH).</p>\n </section>\n \n <section>\n \n <h3> Patients/Methods</h3>\n \n <p>Cord and peripheral blood of neonates &lt; 30 weeks gestational age (GA) was drawn at birth, on days 1 and 3 and fortnightly until 30 weeks corrected gestational age. Prothrombin time (PT), activated partial thromboplastin time (APTT), fibrinogen and coagulation factor levels were measured and tissue factor-stimulated thrombin generation was characterized. Control plasma was obtained from cord blood of term neonates.</p>\n </section>\n \n <section>\n \n <h3> Results</h3>\n \n <p>One hundred and sixteen infants were recruited. Median (range) GA was 27.7 (23.7–29.9) weeks and mean (SD) birth weight was 1020 (255) g. Median (5th–95th percentile) day 1 PT, APTT and fibrinogen were 17.5 (12.7–26.6) s, 78.7 (48.7–134.3) s and 1.4 (0.72–3.8) g L<sup>−1</sup>, respectively.</p>\n \n <p>No difference in endogenous thrombin potential between preterm and term plasma was observed, where samples were available. Levels of coagulation factors II, VII, IX and X, protein C, protein S and antithrombin were reduced in preterm compared with term plasma. Day 1 APTT and PT were not associated with IVH.</p>\n </section>\n \n <section>\n \n <h3> Conclusion</h3>\n \n <p>In the largest cross-sectional study to date of very preterm infants, typical ranges for standard coagulation tests were determined. Despite long clotting times, thrombin generation was observed to be similar in very preterm and term infants.</p>\n </section>\n </div>","PeriodicalId":17326,"journal":{"name":"Journal of Thrombosis and Haemostasis","volume":"13 11","pages":"2021-2030"},"PeriodicalIF":5.0000,"publicationDate":"2015-09-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1111/jth.13130","citationCount":"46","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"Journal of Thrombosis and Haemostasis","FirstCategoryId":"3","ListUrlMain":"https://onlinelibrary.wiley.com/doi/10.1111/jth.13130","RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q1","JCRName":"HEMATOLOGY","Score":null,"Total":0}
引用次数: 46

Abstract

Background

Very premature infants are at high risk of bleeding complications; however, few data exist on ranges for standard coagulation tests.

Objectives

The primary objective of this study was to measure standard plasma coagulation tests and thrombin generation in very premature infants compared with term infants. The secondary objective was to evaluate whether an association existed between coagulation indices and intraventricular hemorrhage (IVH).

Patients/Methods

Cord and peripheral blood of neonates < 30 weeks gestational age (GA) was drawn at birth, on days 1 and 3 and fortnightly until 30 weeks corrected gestational age. Prothrombin time (PT), activated partial thromboplastin time (APTT), fibrinogen and coagulation factor levels were measured and tissue factor-stimulated thrombin generation was characterized. Control plasma was obtained from cord blood of term neonates.

Results

One hundred and sixteen infants were recruited. Median (range) GA was 27.7 (23.7–29.9) weeks and mean (SD) birth weight was 1020 (255) g. Median (5th–95th percentile) day 1 PT, APTT and fibrinogen were 17.5 (12.7–26.6) s, 78.7 (48.7–134.3) s and 1.4 (0.72–3.8) g L−1, respectively.

No difference in endogenous thrombin potential between preterm and term plasma was observed, where samples were available. Levels of coagulation factors II, VII, IX and X, protein C, protein S and antithrombin were reduced in preterm compared with term plasma. Day 1 APTT and PT were not associated with IVH.

Conclusion

In the largest cross-sectional study to date of very preterm infants, typical ranges for standard coagulation tests were determined. Despite long clotting times, thrombin generation was observed to be similar in very preterm and term infants.

Abstract Image

从脐带血和产后样本测定极早产儿凝血指标
非常早产的婴儿出血并发症的风险很高;然而,关于标准凝血试验范围的数据很少。本研究的主要目的是比较早产儿和足月儿的标准血浆凝血试验和凝血酶生成。次要目的是评估凝血指数与脑室内出血(IVH)之间是否存在关联。患者/方法新生儿脐血及外周血;在出生时、第1天和第3天、每两周抽取30周胎龄(GA),直到校正胎龄30周。测定凝血酶原时间(PT)、活化的部分凝血活素时间(APTT)、纤维蛋白原和凝血因子水平,并对组织因子刺激的凝血酶生成进行表征。对照血浆取自足月新生儿脐带血。结果共纳入116例婴儿。GA的中位数(范围)为27.7(23.7-29.9)周,平均出生体重(SD)为1020 (255)g。第1天PT、APTT和纤维蛋白原的中位数(第5 - 95百分位数)分别为17.5 (12.7-26.6)s、78.7 (48.7-134.3)s和1.4 (0.72-3.8)g L−1。内源性凝血酶电位在早产儿和足月血浆中没有差异,在有样本的地方观察到。与足月血浆相比,早产儿凝血因子II、VII、IX和X、蛋白C、蛋白S和抗凝血酶水平降低。第1天APTT和PT与IVH无关。结论:在迄今为止最大的极早产儿横断面研究中,确定了标准凝血试验的典型范围。尽管长凝血时间,凝血酶的产生被观察到相似的非常早产儿和足月婴儿。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
求助全文
约1分钟内获得全文 求助全文
来源期刊
Journal of Thrombosis and Haemostasis
Journal of Thrombosis and Haemostasis 医学-外周血管病
CiteScore
24.30
自引率
3.80%
发文量
321
审稿时长
1 months
期刊介绍: The Journal of Thrombosis and Haemostasis (JTH) serves as the official journal of the International Society on Thrombosis and Haemostasis. It is dedicated to advancing science related to thrombosis, bleeding disorders, and vascular biology through the dissemination and exchange of information and ideas within the global research community. Types of Publications: The journal publishes a variety of content, including: Original research reports State-of-the-art reviews Brief reports Case reports Invited commentaries on publications in the Journal Forum articles Correspondence Announcements Scope of Contributions: Editors invite contributions from both fundamental and clinical domains. These include: Basic manuscripts on blood coagulation and fibrinolysis Studies on proteins and reactions related to thrombosis and haemostasis Research on blood platelets and their interactions with other biological systems, such as the vessel wall, blood cells, and invading organisms Clinical manuscripts covering various topics including venous thrombosis, arterial disease, hemophilia, bleeding disorders, and platelet diseases Clinical manuscripts may encompass etiology, diagnostics, prognosis, prevention, and treatment strategies.
×
引用
GB/T 7714-2015
复制
MLA
复制
APA
复制
导出至
BibTeX EndNote RefMan NoteFirst NoteExpress
×
提示
您的信息不完整,为了账户安全,请先补充。
现在去补充
×
提示
您因"违规操作"
具体请查看互助需知
我知道了
×
提示
确定
请完成安全验证×
copy
已复制链接
快去分享给好友吧!
我知道了
右上角分享
点击右上角分享
0
联系我们:info@booksci.cn Book学术提供免费学术资源搜索服务,方便国内外学者检索中英文文献。致力于提供最便捷和优质的服务体验。 Copyright © 2023 布克学术 All rights reserved.
京ICP备2023020795号-1
ghs 京公网安备 11010802042870号
Book学术文献互助
Book学术文献互助群
群 号:604180095
Book学术官方微信