Developmental Hemostasis

Monagle, Paul

doi:10.1016/b978-0-323-35214-7.00118-9

Cited by 4 publications

(5 citation statements)

References 108 publications

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“…16 Prolongation of the aPTT in young pigs was not associated with an increased tendency to bleeding and that is also consistent with observations made in infants. 15 Our investigations showed that platelet parameters (PLT, MPV, P-LCR) in young pigs tended to stabilize in the early period of life, achieving the adult reference values by weeks 4-6 of age. Among plasma coagulation parameters, PT displayed only minor fluctuations in young piglets, attaining the "normal" intervals relatively quickly as well (by week 8).…”

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confidence: 99%

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Age-related changes of platelet and plasma coagulation parameters in young pigs

et al. 2016

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Abstract. The literature on hemostatic processes in swine is sparse and often fragmentary; hence, we conducted our study to characterize age-related changes in selected parameters of primary and secondary hemostasis in 50 growing pigs between day 2 and week 24 of age. We measured platelet count (PLT), mean platelet volume, platelet-to-large cell ratio, prothrombin time, activated partial thromboplastin time (aPTT), thrombin time (TT), and fibrinogen concentration. Among primary hemostasis parameters, PLT underwent the largest fluctuation with the animals' age, ranging from 340 to 730 × 10 9 /L. However, statistical significance was only detected for 4-week-old piglets compared to 18-week-old animals. Of the secondary hemostasis parameters measured, TT and aPTT were the most changeable. Activated partial thromboplastin time displayed a characteristic biphasic course, being relatively short before week 5 of age (17.8-19.9 s) and then becoming much longer (28.7-52.5 s). The aPTTs measured in animals 6 weeks of age and older were statistically different (p < 0.01) from those in younger piglets. The 2 main components of hemostasis, platelet hemostasis and plasma coagulation, did not develop at the same time. It took much longer for secondary hemostasis to stabilize, whereas platelet parameters were stable early in life.

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confidence: 99%

“…16 Prolongation of the aPTT in young pigs was not associated with an increased tendency to bleeding and that is also consistent with observations made in infants. 15…”

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confidence: 99%

Age-related changes of platelet and plasma coagulation parameters in young pigs

et al. 2016

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“…Coagulopathy associated with IUVVs is thought to be induced by the consumption of coagulation factors during thrombus formation and fibrinolysis within the varices. 9 Preterm neonates have significantly lower coagulation factors and coagulation inhibitor activities than term neonates, 15 and the presence of IUVV in a neonate with a premature coagulationfibrinolysis system may be associated with the development of coagulopathy.…”

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confidence: 99%

Severe Consumptive Coagulopathy in an Extremely-Low-Birth-Weight Infant with Intra-Abdominal Umbilical Vein Varix: A Case Report

Haga

Itoh

Horikoshi

et al. 2021

AJP Rep

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Recent studies have shown favorable outcomes for intra-abdominal umbilical vein varices (IUVVs) in term neonates who have no other complications. Little is known, however, about the prognosis of IUVVs in preterm neonates. We encountered a case of IUVV in an extremely low-birth-weight infant who developed severe consumptive coagulopathy after birth. The patient's coagulation test normalized as the varix spontaneously obstructed. Although life-threatening hemorrhagic complications were avoided, a cerebellum hemorrhage was found in the brain magnetic resonance imaging at the term-equivalent age. In a literature survey, coagulopathy was reported in 4 out of 15 infants with IUVVs born before 34 weeks of gestation, including our present case. Preterm infants with IUVVs may develop coagulopathy because of the prematurity of their coagulation–fibrinolysis systems. Attention should be given to the coagulation status of preterm neonates with IUVVs.

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“…That said, the molecular basis underlying age-related numerical changes in coagulation measures as well as the clinical manifestation of these changes is not fully understood. Animal studies have demonstrated structural differences in coagulation proteins in newborn compared to adult models but this work has yet to be translated to humans ( 61 ). Further translational study is necessary to elucidate the important connections between coagulation parameters and clinical thrombotic and bleeding risk.…”

Section: Developmental Hemostasismentioning

confidence: 99%

Hemostatic Testing in Critically Ill Infants and Children

Nair

Parker

2021

Front. Pediatr.

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Children with critical illness frequently manifest imbalances in hemostasis with risk of consequent bleeding or pathologic thrombosis. Traditionally, plasma-based tests measuring clot formation by time to fibrin clot generation have been the “gold standard” in hemostasis testing. However, these tests are not sensitive to abnormalities in fibrinolysis or in conditions of enhanced clot formation that may lead to thrombosis. Additionally, they do not measure the critical roles played by platelets and endothelial cells. An added factor in the evaluation of these plasma-based tests is that in infants and young children plasma levels of many procoagulant and anticoagulant proteins are lower than in older children and adults resulting in prolonged clot generation times in spite of maintaining a normal hemostatic “balance.” Consequently, newer assays directly measuring thrombin generation in plasma and others assessing the stages hemostasis including clot initiation, propagation, and fibrinolysis in whole blood by viscoelastic methods are now available and may allow for a global measurement of the hemostatic system. In this manuscript, we will review the processes by which clots are formed and by which hemostasis is regulated, and the rationale and limitations for the more commonly utilized tests. We will also discuss selected newer tests available for the assessment of hemostasis, their “pros” and “cons,” and how they compare to the traditional tests of coagulation in the assessment and management of critically ill children.

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Developmental Hemostasis

Cited by 4 publications

References 108 publications

Age-related changes of platelet and plasma coagulation parameters in young pigs

Age-related changes of platelet and plasma coagulation parameters in young pigs

Severe Consumptive Coagulopathy in an Extremely-Low-Birth-Weight Infant with Intra-Abdominal Umbilical Vein Varix: A Case Report

Hemostatic Testing in Critically Ill Infants and Children

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