Heparin for the prevention of intraventricular haemorrhage in preterm infants

Bruschettini, Matteo; Romantsik, Olga; Zappettini, Simona; Banzi, Rita; Ramenghi, Luca A.; Calevo, Maria Grazia

doi:10.1002/14651858.cd011718.pub2

Cited by 9 publications

(9 citation statements)

References 56 publications

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“…Interestingly, low‐dose heparin has been proposed as a possible prophylactic treatment for IVH, the rationale being that thrombi formation the central venous system may contribute to the development of IVH 66 . While a meta‐analysis showed no benefit of low‐dose heparin (1 U/mL), it also showed no harm at that dose 67 . Therefore, decreasing the anticoagulation requirement to the low‐dose heparin range may be compatible with artificial placenta use in EPT neonates.…”

Section: Designing Next‐generation Oxygenators For the Artificial Plamentioning

confidence: 98%

“…66 While a meta-analysis showed no benefit of low-dose heparin (1 U/mL), it also showed no harm at that dose. 67 Therefore, decreasing the anticoagulation requirement to the low-dose heparin range may be compatible with artificial placenta use in EPT neonates. There are several avenues by which the need for anticoagulation in an oxygenator can be reduced.…”

Section: Minimal Anticoagulationmentioning

confidence: 99%

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Advances in extracorporeal membrane oxygenator design for artificial placenta technology

et al. 2020

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Extreme prematurity, defined as a gestational age of fewer than 28 weeks, is a significant health problem worldwide. It carries a high burden of mortality and morbidity, in large part due to the immaturity of the lungs at this stage of development. The standard of care for these patients includes support with mechanical ventilation, which exacerbates lung pathology. Extracorporeal life support (ECLS), also called artificial placenta technology when applied to extremely preterm (EPT) infants, offers an intriguing solution. ECLS involves providing gas exchange via an extracorporeal device, thereby doing the work of the lungs and allowing them to develop without being subjected to injurious mechanical ventilation. While ECLS has been successfully used in respiratory failure in full‐term neonates, children, and adults, it has not been applied effectively to the EPT patient population. In this review, we discuss the unique aspects of EPT infants and the challenges of applying ECLS to these patients. In addition, we review recent progress in artificial placenta technology development. We then offer analysis on design considerations for successful engineering of a membrane oxygenator for an artificial placenta circuit. Finally, we examine next‐generation oxygenators that might advance the development of artificial placenta devices.

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Section: Designing Next‐generation Oxygenators For the Artificial Plamentioning

confidence: 98%

Section: Minimal Anticoagulationmentioning

confidence: 99%

Advances in extracorporeal membrane oxygenator design for artificial placenta technology

et al. 2020

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“…e human CCVD-related diseases associated with genes were secured from the curative targets database such as the Online Mendelian Inheritance in Man (OMIM, http:// www.omim.org/) and Pharmacogenomics Knowledgebase (PharmGKB; http://www.pharmgkb.org) [29][30][31][32]. e keywords were "stroke," "anti-platelet aggregation," "atherosclerosis," "improving microcirculation," and "antithrombin" [33][34][35].…”

Section: Target Fishing Drug Target Indentifying Is Momentousmentioning

confidence: 99%

A Systems Pharmacology Approach for Identifying the Multiple Mechanisms of Action for the Rougui‐Fuzi Herb Pair in the Treatment of Cardiocerebral Vascular Diseases

Liu

et al. 2020

Evidence-Based Complementary and Alternative Medicine

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Cardiocerebral vascular diseases (CCVDs) are the main reasons for high morbidity and mortality all over the world, including atherosclerosis, hypertension, myocardial infarction, stroke, and so on. Chinese herbs pair of the Cinnamomum cassia Presl (Chinese name, rougui) and the Aconitum carmichaelii Debx (Chinese name, fuzi) can be effective in CCVDs, which is recorded in the ancient classic book Shennong Bencao Jing, Mingyibielu and Thousand Golden Prescriptions. However, the active ingredients and the molecular mechanisms of rougui-fuzi in treatment of CCVDs are still unclear. This study was designed to apply a system pharmacology approach to reveal the molecular mechanisms of the rougui-fuzi anti-CCVDs. The 163 candidate compounds were retrieved from Traditional Chinese Medicine System Pharmacology Database and Analysis Platform (TCMSP). And 84 potential active compounds and the corresponding 42 targets were obtained from systematic model. The underlying mechanisms of the therapeutic effect for rougui-fuzi were investigated with gene ontology (GO) enrichment analysis and Kyoto Encyclopedia of Genes and Genomes (KEGG) pathway enrichment analysis. Then, component-target-disease (C-T-D) and target-pathway (T-P) networks were constructed to further dissect the core pathways, potential targets, and active compounds in treatment of CCVDs for rougui-fuzi. We also constituted protein-protein in interaction (PPI) network by the reflect target protein of the crucial pathways against CCVDs. As a result, 21 key compounds, 8 key targets, and 3 key pathways were obtained for rougui-fuzi. Afterwards, molecular docking was performed to validate the reliability of the interactions between some compounds and their corresponding targets. Finally, UPLC-Q-Exactive-MSE and GC-MS/MS were analyzed to detect the active ingredients of rougui-fuzi. Our results may provide a new approach to clarify the molecular mechanisms of Chinese herb pair in treatment with CCVDs at a systematic level.

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Section: Intraventricular Hemorrhage (Ivh)mentioning

confidence: 99%

“…A recent review found that antithrombin administration doesn't reduce the incidence of IVH in very low-birth-weight preterm when compared to placebo, no treatment, and heparin [59]. Additional studies are warranted to illustrate the effect of heparin as a preventive agent for IVH [60].Lung Injury: Surfactant deficiency, immature lung structure, and poorly developed respiratory mechanisms are the main causes of lung injury among preterm neonates. Therefore, respiratory support is generally recommended for that high-risk group to maintain functional residual capacity and avoid lung damage.…”

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confidence: 99%

The First Sixty Minutes in Preterm Neonates’ Life: Predicted Morbidities and Interventions

El-Atawi¹

2018

JPNC

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Preterm neonates are more vulnerable to many diseases and complications than full-term infants as most of their biological systems are still underdeveloped. Fortunately, most of these morbidities are preventable as there are many interventions that could be performed in the first 60 minutes of neonatal life to avoid them and their long-term consequences, thus rightfully defining 'the golden hour'. The objective of this article is to review the potential morbidities that neonates might experience and understand their mechanisms, risk factors and its possible outcomes. We also reviewed the possible actions that could be implemented during the golden hour to prevent these morbidities and investigated their effectiveness. Medline and Cochrane database for systematic review were the main two electronic database that we used to search for studies. Studies pertaining to morbidities, such as hypothermia, hypoglycemia, respiratory distress, intraventricular hemorrhage (IVH), Chronic lung disease (CLD) and retinopathy of prematurity (ROP) have been selected according to their full text accessibility for us. Reports related to possible interventions that could be performed to prevent these morbidities have also been involved that include but not only restricted to drying & head coverings, polyethylene occlusive skin wraps, ambient room temperature, pre-warmed incubator, heated humidified gases, heated mattress and skin-to-skin contact for hypothermia; dextrose infusion pump, dextrose burette and oral dextrose for hypoglycemia; indomethacin, ibuprofen, antithrombin and heparin for IVH; surfactant and CPAP for respiratory distress; controlling oxygen saturation for ROP. Keywords: The First Sixty Minutes in Preterm Neonates' Life: Predicted Morbidities and Interventions 2/8Copyright: ©2018 El-Atawi et al. the relation between severe hypothermia (<32°C) and shortand long-term neurodevelopmental outcomes are required. Moderate hypothermia was found to be associated with severe intraventricular hemorrhage, intraventricular leukomalacia, and necrotizing enterocolitis. Yet, these associations should be analyzed carefully since they were based on studies with a wide confidence interval. More studies with larger sample size are warranted to accurately illustrate these associations [5]. Moreover, hypothermia increases oxygen consumption, thus leading to hypoxia and subsequently pulmonary vasoconstriction which, in turn, declines surfactant production and worsens respiratory distress. The presence of comorbidities with hypothermia increases the fatality rate, so adding a higher category to the severity of hypothermia would represent an effective addition to the WHO classification of the severity of hypothermia [8].Large surface area of neonates in relation to their small body weight makes them more vulnerable to hypothermia than fullterm babies. Preterm neonates have a higher transepidermal water loss than term due to their immature epidermal layer [9]. Their premature vasomotor control which acts as a thermoregulatory mec...

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Heparin for the prevention of intraventricular haemorrhage in preterm infants

Cited by 9 publications

References 56 publications

Advances in extracorporeal membrane oxygenator design for artificial placenta technology

Advances in extracorporeal membrane oxygenator design for artificial placenta technology

A Systems Pharmacology Approach for Identifying the Multiple Mechanisms of Action for the Rougui‐Fuzi Herb Pair in the Treatment of Cardiocerebral Vascular Diseases

The First Sixty Minutes in Preterm Neonates’ Life: Predicted Morbidities and Interventions

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