Bleeding Disorders in Congenital Syndromes

Sarangi, Susmita N.; Acharya, Suchitra S.

doi:10.1542/peds.2015-4360

Cited by 14 publications

(10 citation statements)

References 47 publications

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“…Neonates with the following conditions were excluded, based on studies that these conditions might have an effect on the RDW: (1) congenital malformations, (2) chromosomal abnormalities, (3) congenital infections due to the TORCH complex, (4) metabolic disease, (5) Rh or ABO incompatibility, (6) already on antibiotics in whom no blood culture was done, (7) had blood transfusion before the sepsis evaluation was done, and (8) perinatal asphyxia. [5][6][7] After cases (bacteremic neonates) were identified, gestational-age-matched non-bacteremic controls were obtained by simple random sampling, with a 1:4 ratio.…”

Section: Methodsmentioning

confidence: 99%

Red Cell Distribution Width and Its Association with Neonatal Bacteremia: A Case-Control Study

Diamla¹,

Garcia²

2022

PIDSPJ

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Background: Bacteremia is a major cause of prolonged hospital stay and mortality in neonates and its early diagnosis remains a challenge to pediatricians. Red cell distribution width (RDW) is a component of a complete blood count test which is accessible and inexpensive and has been reported to be a possible diagnostic marker for neonatal bacteremia. This study determined the association of RDW with neonatal bacteremia in term and preterm neonates. Methodology: This is a retrospective case-control study of 26 bacteremic neonates as cases and 104 non-bacteremic neonates, either symptomatic or with risk factors for bacteremia, as controls. Included newborns were seen between January 1, 2010 to September 30, 2021. Laboratory data obtained were CBC, C-reactive protein and blood culture. Results: RDW values between bacteremic and non-bacteremic neonates were not significantly different. There was an association between RDW and neonatal bacteremia at an RDW level of > 16.1, where the likelihood of bacteremia was three times higher compared with lower RDW values. Significantly lower levels of hemoglobin, hematocrit, RBC count, WBC count, platelet count, MCH and MCHC, and a higher CRP level were seen among bacteremic neonates compared to those who were not. The median RDW for both term and preterm neonates was close to 16, with a narrow inter-quartile range at 1 and 2 for controls and cases, respectively. The range (minimum to maximum) of RDW values of bacteremic preterm neonates was more variable than those of term neonates. Using RDW to detect bacteremia, it had an equivocal discriminatory power or AUC of 0.6056. We found insufficient evidence to demonstrate a correlation between RDW and other CBC parameters, except for MCHC. For MCHC, the results suggest a very weak and indirect correlation. Conclusion: RDW was not significantly different between bacteremic and non-bacteremic neonates, but there was a suggested association between RDW and bacteremia at an RDW level of > 16.1, at which level there was a 3-fold risk for bacteremia.

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Section: Methodsmentioning

confidence: 99%

Red Cell Distribution Width and Its Association with Neonatal Bacteremia: A Case-Control Study

Diamla¹,

Garcia²

2022

PIDSPJ

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“…Coagulation testing prior to procedures should be considered for patients with significant personal or family history of bleeding and/or high‐risk procedures. Patients with congenital disorders that may increase risk of bleeding such as DiGeorge syndrome, Noonan syndrome, Jacobsen syndrome, and connective tissue disease (Ehlers‐Danlos syndrome) require careful observation 112 . Tests performed should be guided by the type of procedure, bleeding history, medication history, and patient's comorbidities.…”

Section: Perioperative Pbmmentioning

confidence: 99%

“…Participant use data files (PUFs) from the National Surgical Quality Improvement Program – Paediatrics (NSCIP‐P) from 2012 to 2015 revealed 5.8% of general surgical cases require a blood transfusion 112 . The two most common surgery groups requiring transfusion were spinal fusions (64.9%) and craniosynostosis (62.1%) 112 . Solid organ transplant and cardiac surgeries are not included in the NSCIP‐P data.…”

Section: Perioperative Pbmmentioning

confidence: 99%

“…Solid organ transplant and cardiac surgeries are not included in the NSCIP‐P data. Benchmarking models using PUFs can be used to follow specific metrics and patient outcomes 112 . Focusing PBM optimization efforts on the cardiology, craniofacial and spinal deformity surgical populations may be most advantageous 116,127,128 .…”

Section: Perioperative Pbmmentioning

confidence: 99%

“…127 The two most common surgery groups requiring transfusion were spinal fusions (64.9%) and craniosynostosis (62.1%). 112 Solid organ transplant and cardiac surgeries are not included in the NSCIP-P data.…”

Section: Perioperative Cell Salvagementioning

confidence: 99%

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Transfusion therapy of neonatal and paediatric patients: They are not just little adults

Gammon

Al‐Mozain

Aurón

et al. 2022

Transfusion Medicine

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Patient blood management (PBM) strategies are needed in the neonate and paediatric population, given that haemoglobin thresholds used are often higher than recommended by evidence, with exposure of children to potential complications without meaningful benefit. A literature review was performed on the following topics: evidence-based transfusions of blood components and pharmaceutical agents. Other topics reviewed included perioperative coagulation assessment and perioperative PBM. The Transfusion and Anaemia Expertise Initiative (TAXI) consortium published a consensus statement addressing haemoglobin (Hb) transfusion threshold in multiple subsets of patients. A multicentre trial (PlaNeT-2) reported a higher risk of bleeding and death or serious new bleeding among infants who received platelet transfusion at a higher (50 000/μl) compared to a lower (25 000/μl) threshold. Recent data support the use of a restrictive transfusion threshold of 25 000/μl for prophylactic platelet transfusions in preterm neonates. The TAXI-CAB consortium mentioned that in critically ill paediatric patients undergoing invasive procedures outside of the operating room, platelet transfusion might be considered when the platelet count is less than or equal to 20 000/μl and there is no benefit of platelet transfusion when the platelet count is more than 50 000/μl. There are limited controlled studies in paediatric and neonatal population regarding plasma transfusion. Blood conservation strategies to minimise allogenic blood exposure are essential to positive patient outcomes neonatal and paediatric transfusion practices have changed significantly in recent years since randomised controlled trials were published to guide practice. Additional studies are needed in order to provide practice change recommendations.

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Quantitative changes in blood cells

2021

Blood Cells

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Bleeding Disorders in Congenital Syndromes

Cited by 14 publications

References 47 publications

Red Cell Distribution Width and Its Association with Neonatal Bacteremia: A Case-Control Study

Red Cell Distribution Width and Its Association with Neonatal Bacteremia: A Case-Control Study

Transfusion therapy of neonatal and paediatric patients: They are not just little adults

Quantitative changes in blood cells

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