Platelet dysfunction and coagulopathy in intraventricular hemorrhage in the premature infant

Behrman, Richard E.; Setzer, Emmalee S.; Webb, Iva B.; Wassenaar, John W; Reeder, John D.; Mehta, Paulette; Eitzman, Donald V.

doi:10.1016/s0022-3476(82)80766-x

Cited by 109 publications

(8 citation statements)

References 22 publications

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“…Two possible explanations have been propagated; thrombocytopenia might have caused the IVH, or it was a result of IVH through a consumptive process. [ 25 28 ] Our results illustrate that probably thrombocytopenia is not the main trigger for IVH and other factors contribute to its pathogenesis.…”

Section: Discussionmentioning

confidence: 71%

“…In patients with severe thrombocytopenia and in contrast to cutaneous and gastrointestinal hemorrhage no relationship between the lowest platelet count recorded, and the presence of IVH or pulmonary hemorrhage were found. [ 28 ] Furthermore, it was not clear how to interpret the association seen in some studies between lower platelets counts and higher prevalence of IVH. Two possible explanations have been propagated; thrombocytopenia might have caused the IVH, or it was a result of IVH through a consumptive process.…”

Section: Discussionmentioning

confidence: 99%

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Prognostic significance of early platelet count decline in preterm newborns

Elmoneim

Zolaly

elmoneim

et al. 2015

Indian Journal of Critical Care Medicine

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Objectives:Decline of platelets with or without thrombocytopenia is observed in critically ill preterm newborns. Prognostic significance of platelets count in Neonatal Intensive Care Unit focused on outcome after thrombocytopenia. We aimed to estimate the changes in platelets count within the first 7 days of life in preterm newborns and its relation to final outcomes.Methods:Retrospectively, the platelets count during the first 7 days of life, and its association with mortality, length of stay among survivors (LOS), and later severe morbidities were determined. Appropriate regression analyses were used to examine possible relations between studied variables.Results and Discussion:Platelets drop that did not reach thrombocytopenia level in the first 7 days of life happened in 61.7%. Platelets count drop in the first 7 days of life was a predictor of mortality, LOS, and major morbidities such as intraventricular hemorrhage and necrotizing enterocolitis.Conclusions:Platelets count drop within the first 7 days of life independent of thrombocytopenia can be used to predict increased mortality, LOS, and the development of later severe morbidities in critically ill preterm neonates.

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Section: Discussionmentioning

confidence: 71%

Section: Discussionmentioning

confidence: 99%

Prognostic significance of early platelet count decline in preterm newborns

Elmoneim

Zolaly

elmoneim

et al. 2015

Indian Journal of Critical Care Medicine

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“…Extremely low birth weight infants are at risk for hemorrhaging because their platelets are hypoactive and bleeding times are long, especially on day 1 (5, 6, 23, 24). Bleeding times, although difficult to measure, reportedly improve with transfusions of adult platelets (25).…”

Section: Discussionmentioning

confidence: 99%

“…Theoretically, IVH could be prevented by limiting germinal matrix layer hemorrhages (GMH) from enlarging and rupturing into the cerebral ventricles (Figure 1). Studies have suggested that extremely low birth weight (ELBW) infants may not be able to accomplish this because of their innately limited hemostatic capacity (4–6). One facet of their coagulation system that is not limited, however, is the concentration of circulating platelets.…”

Section: Introductionmentioning

confidence: 99%

Preventing Germinal Matrix Layer Rupture and Intraventricular Hemorrhage

Coen¹

2013

Front. Pediatr.

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The etiology of intraventricular hemorrhage (IVH) in extremely low birth weight preterm infants is multifactorial with circulatory instability and hemostasis being preeminent. This study sought to determine if the germinal matrix layer remained intact when platelets were above 200 × 109/L, a near normal level, and fell below that when IVH occurred. This was a retrospective study of platelets and head ultrasounds (HUS) in infants 23–28 weeks gestation. Analyses were descriptive, one way analysis of variance, Pearson Chi-square tests, and t-tests. Platelet counts and HUS were linked in 114 infants during the first 3 days when 90% of IVHs occur. Mean platelet levels were >200 × 109/L in 68% of infant 23–24 weeks gestation and 78% of those 25–26 weeks when there were no IVHs. These findings, if confirmed, suggest that improving hemostasis in high risk preterm infants by keeping platelet levels >200 × 109/L may maintain the integrity of the germinal matrix layer and prevent IVHs.

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“…In one study with 58 infants, only two infants with IVH had low platelet counts and prolonged bleeding, and two more had minor decreases in platelet counts but normal bleeding times(10). Another study with 97 subjects found an association between prolonged bleeding times and a platelet count <100,000, but this association was not linear or precise(11).…”

Section: Transfusion Strategiesmentioning

confidence: 99%

One size will never fit all: the future of research in pediatric transfusion medicine

Josephson

Mondoro

Ambruso³

et al. 2014

Pediatr Res

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There is concern at the National Heart, Lung, and Blood Institute (NHLBI) and among transfusion medicine specialists regarding the small number of investigators and studies in the field of pediatric transfusion medicine (PTM). Accordingly, the objective of this article is to provide a snapshot of the clinical and translational PTM research considered to be of high priority by pediatricians, neonatologists, and transfusion medicine specialists. Included is a targeted review of three research areas of importance: 1) transfusion strategies, 2) short- and long-term clinical consequences, and 3) transfusion-transmitted infectious diseases. The recommendations by PTM and transfusion medicine specialists represent opportunities and innovative strategies to execute translational research, observational studies, and clinical trials of high relevance to PTM. With the explosion of new biomedical knowledge and increasingly sophisticated methodologies over the past decade, this is an exciting time to consider transfusion medicine as a paradigm for addressing questions related to fields such as cell biology, immunology, neurodevelopment, outcomes research and many others. Increased awareness of PTM as an, important, fertile field and the promotion of accompanying opportunities will help establish PTM as a viable career option and advance basic and clinical investigation to improve the health and wellbeing of children.

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Platelet dysfunction and coagulopathy in intraventricular hemorrhage in the premature infant

Cited by 109 publications

References 22 publications

Prognostic significance of early platelet count decline in preterm newborns

Prognostic significance of early platelet count decline in preterm newborns

Preventing Germinal Matrix Layer Rupture and Intraventricular Hemorrhage

One size will never fit all: the future of research in pediatric transfusion medicine

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