Gastrointestinal Bleeding in the Neonate: Updates on Diagnostics, Therapeutics, and Management

We conducted a systematic review aiming to summarize the data on the current hemorrhage prediction models and evaluate their potential for generalized application in the neonatal population. The electronic databases PubMed and Scopus were searched, up to September 20, 2023, for studies that focused on development and/or validation of a prediction model for bleeding risk in neonates, and described the process of model building. Nineteen studies fulfilled the inclusion criteria for the present review. Eighteen bleeding risk prediction models in the neonatal population were identified, four of which were internally validated, one temporally and one externally validated. The existing prediction models for neonatal hemorrhage are mostly based on clinical variables and do not take into account the clinical course and hemostatic profile of the neonates. Most studies aimed at predicting the risk of intraventricular hemorrhage (IVH) reflecting the fact that IVH is the most frequent and serious bleeding complication in preterm neonates. A justification for the study sample size for developing the prediction model was given only by one study. Prediction and stratification of risk of hemorrhage in neonates is yet to be optimized. To this end, qualitative standards for model development need to be further improved. The assessment of the risk of bleeding incorporating platelet count, coagulation parameters, and a set of relevant clinical variables is crucial. Large, rigorous, collaborative cohort studies are warranted to develop a robust prediction model to inform the need for transfusion, which is a fundamental step towards personalized transfusion therapy in neonates.

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Wireless, Multimodal Monitoring of Organ Health Using 3D-Printed, Barbed, Bioresorbable Stretchable Microneedle Sensor Arrays

Li,

Liu,

et al. 2024

Preprint

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Comprehensive and continuous assessment of organ physiology and biochemistry, beyond the capabilities of conventional monitoring tools, can enable timely interventions for intraoperative complications like organ ischemia and nerve injuries and postoperative conditions such as organ dysfunction and transplant rejection. Here, we report a wireless implant with a 3D-printed, barbed, bioresorbable stretchable microneedle sensor array that offers multimodal monitoring of organ metabolism, oxygenation, and electrophysiology as well as spatiotemporal mapping of biomarkers across different organ regions. The development of a deformation-coupled 3D-printing technique enables 3D-programmable manufacturing of microneedles with monolithic backward-facing barbs, offering conformal yet robust 3D probing of organs with dynamic mechanics. Electrochemical functionalization of microneedle tips serves as a universal approach for localized sensing of physiological and biochemical parameters, enabling concurrent monitoring of up to 36 parameters (glucose, uric acid, oxygen,etc.) and spatiotemporal mapping of up to 32 sites. An electrically programmable self-destruction mechanism based on crevice corrosion and bioresorption eliminates the need for traumatic retrieval of microneedles. Demonstrations in clinically relevant complications like kidney ischemia and gut disorders in animal models highlight the broad applications of this device in intra- and postoperative monitoring.

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Gastrointestinal Bleeding in the Neonate: Updates on Diagnostics, Therapeutics, and Management

Cited by 4 publications

References 46 publications

Hémorragie digestive

Hémorragie digestive

Bleeding Scoring Systems in Neonates: A Systematic Review

Wireless, Multimodal Monitoring of Organ Health Using 3D-Printed, Barbed, Bioresorbable Stretchable Microneedle Sensor Arrays

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