Coagulation assay results at birth in preterm infants: A cohort study highlighting the relevance of local reference values for interpretation.

IF 1.8 4区医学 Q3 HEMATOLOGY

Vox Sanguinis Pub Date : 2024-11-18 DOI:10.1111/vox.13766

Nina Houben, Suzanne Fustolo-Gunnink, Camila Caram-Deelder, Remco Visser, Madeleen Bosma, Karin Fijnvandraat, Jeroen Eikenboom, Johanna van der Bom, Enrico Lopriore

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引用次数: 0

Abstract

Background and objectives: Routine coagulation screens at birth are still standard in some European neonatal intensive care units (NICUs), although interpretation of these results is complex in preterm infants. It is unclear to what extent local coagulation assay results agree with published reference ranges when using different analysers and reagents. We aimed to assess coagulation assay results on day 1 of life in very preterm infants admitted to the NICU.

Materials and methods: We included all preterm infants born below 32 weeks gestational age (GA) admitted to the Leiden University Medical Center between 2004 and 2020 in whom coagulation assays (prothrombin time [PT] and activated partial thromboplastin time [APTT]) were obtained during the first 24 h of life. Infants either diagnosed with major intraventricular haemorrhage or who received plasma transfusion before coagulation assay were excluded. We assessed coagulation assay results and compared the results between <28 weeks (extremely preterm) and 28-32 weeks (very preterm) GA groups.

Results: Coagulation assays were obtained at birth in 144 infants (144/2577; 5.5%) of whom 104 fulfilled the inclusion criteria. We found similar median PT and APTT values for extremely and very preterm infants (PT: 18.1 vs. 18.7 s [p-value = 0.400]; APTT: 44.2 vs. 47.7 s [p-value = 0.252], respectively).

Conclusion: We found similar coagulation assay results at birth for extremely and very preterm infants; however, results deviated considerably from some of the published reference ranges. This may be due to differences between analysers and reagents, underlining the need for reference ranges calibrated to the equipment used per NICU.

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早产儿出生时的凝血测定结果：一项队列研究强调了当地参考值对解读的相关性。

背景和目的：在欧洲的一些新生儿重症监护室（NICU）中，出生时的常规凝血筛查仍是标准做法，但对于早产儿来说，对这些结果的解释非常复杂。目前还不清楚在使用不同分析仪和试剂的情况下，当地的凝血测定结果在多大程度上与公布的参考范围一致。我们的目的是评估入住新生儿重症监护室的极早产儿出生后第一天的凝血测定结果：我们纳入了 2004 年至 2020 年期间莱顿大学医疗中心收治的所有胎龄低于 32 周的早产儿，这些早产儿在出生后 24 小时内进行了凝血测定（凝血酶原时间 [PT] 和活化部分凝血活酶时间 [APTT]）。被诊断为脑室内大出血或在凝血测定前接受过血浆输注的婴儿除外。我们对凝血测定结果进行了评估，并对不同结果进行了比较：144 名婴儿（144/2577；5.5%）在出生时接受了凝血测定，其中 104 名符合纳入标准。我们发现极早产儿和极早产儿的 PT 和 APTT 中位值相似（PT：18.1 vs. 18.7 s [p-value = 0.400]；APTT：44.2 vs. 47.7 s [p-value = 0.252]）：我们发现极早产儿和极早产儿出生时的凝血检测结果相似，但结果与一些已公布的参考范围有很大偏差。这可能是由于分析仪和试剂之间的差异造成的，因此需要根据每个新生儿重症监护室使用的设备校准参考范围。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Vox Sanguinis 医学-血液学

CiteScore

4.40

自引率

11.10%

发文量

156

审稿时长

6-12 weeks

期刊介绍： Vox Sanguinis reports on important, novel developments in transfusion medicine. Original papers, reviews and international fora are published on all aspects of blood transfusion and tissue transplantation, comprising five main sections: 1) Transfusion - Transmitted Disease and its Prevention: Identification and epidemiology of infectious agents transmissible by blood; Bacterial contamination of blood components; Donor recruitment and selection methods; Pathogen inactivation. 2) Blood Component Collection and Production: Blood collection methods and devices (including apheresis); Plasma fractionation techniques and plasma derivatives; Preparation of labile blood components; Inventory management; Hematopoietic progenitor cell collection and storage; Collection and storage of tissues; Quality management and good manufacturing practice; Automation and information technology. 3) Transfusion Medicine and New Therapies: Transfusion thresholds and audits; Haemovigilance; Clinical trials regarding appropriate haemotherapy; Non-infectious adverse affects of transfusion; Therapeutic apheresis; Support of transplant patients; Gene therapy and immunotherapy. 4) Immunohaematology and Immunogenetics: Autoimmunity in haematology; Alloimmunity of blood; Pre-transfusion testing; Immunodiagnostics; Immunobiology; Complement in immunohaematology; Blood typing reagents; Genetic markers of blood cells and serum proteins: polymorphisms and function; Genetic markers and disease; Parentage testing and forensic immunohaematology. 5) Cellular Therapy: Cell-based therapies; Stem cell sources; Stem cell processing and storage; Stem cell products; Stem cell plasticity; Regenerative medicine with cells; Cellular immunotherapy; Molecular therapy; Gene therapy.