Umbilical cord blood as a replacement source for admission complete blood count in premature infants

Carroll, Patrick; Nankervis, Craig A.; Iams, Jay D.; Kelleher, Kelly J.

doi:10.1038/jp.2011.60

Cited by 60 publications

(90 citation statements)

References 27 publications

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“…Previous studies by our study group and others evaluated the agreement of paired CBC samples, i.e., drawn directly from a neonate and from an umbilical vein after placental delivery [1, 2, 6]. However, we believe this to be the first report evaluating the effect of the passage of time following placental delivery on CBC parameters drawn from an umbilical vein.…”

Section: Discussioncontrasting

confidence: 39%

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Evaluating Otherwise-Discarded Umbilical Cord Blood as a Source for a Neonate’s Complete Blood Cell Count at Various Time Points

et al. 2018

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Background: Previous studies have reported the use of cord blood for admission laboratory complete blood counts (CBCs). However, no studies have investigated its stability for the first 30 min after delivery. Objectives: We quantified blood cells drawn from the umbilical vein to determine the effect of (1) the time after placental delivery, and (2) the site of blood sampling (umbilical vein on an isolated cord segment vs. umbilical vein on the placental surface). Methods: Timed phlebotomies were drawn at 2, 10, and 30 min from (1) the umbilical vein on an isolated, double-clamped cord segment, and (2) the umbilical vein near or on the placental surface. Leukocyte count, hemoglobin, platelet count, and fibrinogen were measured on each phlebotomy sample. Results: Blood drawn from the isolated umbilical cord segments had leukocyte count, hemoglobin, platelet count, and fibrinogen that remained unchanged between the phlebotomies at 2, 10, and 30 min after delivery. However, blood drawn from the umbilical vein on the placental surface had, at 30 min, a leukocyte count (p = 0.002), hemoglobin (p = 0.01), and platelet count (p = 0.001) that were statistically different from the values at 2 and 10 min after delivery. There was no difference in fibrinogen at 2, 10, or 30 min. Conclusions: If cord blood is used for a neonate’s initial CBC, the blood should be drawn within 10 min of the placental delivery when it is taken from the umbilical vein on or near the placenta. If an umbilical cord segment is obtained, the phlebotomy can be delayed for up to 30 min.

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Section: Discussioncontrasting

confidence: 39%

“…It is optimal to obtain cord blood or placental blood immediately after delivering the placenta; this has been previously described [2-5]. However, when all neonatal personnel attending a delivery are needed for the resuscitation of the neonate, drawing blood from the placenta or cord immediately may not be possible.…”

Section: Introductionmentioning

confidence: 99%

Evaluating Otherwise-Discarded Umbilical Cord Blood as a Source for a Neonate’s Complete Blood Cell Count at Various Time Points

et al. 2018

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“…In paired samples, complete blood count and manual differential count are clinically equivalent [18,19]. Blood culture results from umbilical cord segments or fetal vessels on the placenta have been investigated in several studies [17,18,19,20,21,22,23].…”

Section: Rbc Transfusionmentioning

confidence: 99%

Evidence-Based Advances in Transfusion Practice in Neonatal Intensive Care Units

2014

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Background: Transfusions to neonates convey both benefits and risks, and evidence is needed to guide wise use. Such evidence is accumulating, but more information is needed to generate sound evidence-based practices. Objective: We sought to analyze published information on nine aspects of transfusion practice in neonatal intensive care units. Methods: We assigned ‘categories of evidence' and ‘recommendations' using the format of the United States Preventive Services Task Force of the Agency for Healthcare Research and Quality. Results: The nine practices studied were: (1) delayed clamping or milking of the umbilical cord at preterm delivery - recommended, high/substantial A; (2) drawing the initial blood tests from cord/placental blood from very low birth weight (VLBW, <1,500 g) infants at delivery - recommended, moderate/moderate B; (3) limiting phlebotomy losses of VLBW infants - recommended, moderate/substantial B; (4) selected use of erythropoiesis-stimulating agents to prevent transfusions - recommended, moderate/moderate-moderate/small B, C; (5) using platelet mass, rather than platelet count, in platelet transfusion decisions - recommended, moderate/small C; (6) permitting the platelet count to fall to <20,000/µl in ‘stable' neonates before transfusing platelets - recommended, low/small I; (8) permitting the platelet count to fall to <50,000/µl in ‘unstable' neonates before transfusing platelets - recommended, moderate/small C, and (9) not performing routine coagulation test screening on every VLBW infant - recommended, moderate/small C. Conclusions: We view these recommendations as dynamic, to be revised as additional evidence becomes available. We predict this list will expand as new studies provide more information to guide best transfusion practices.

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“…Umbilical cord blood (UCB) is remained blood in the placenta and atached umbilical cord after the birth of baby. Several studies suggest that UCB could be an alternative source for admission of blood tests in neonates [1,3,4]. Especially, very low birth weight infants who typically have greater phlebotomy blood loss on the irst day of life than any other day during their hospitalization would beneit most from admission laboratory studies being obtained from UCB [5,6].…”

Section: Introductionmentioning

confidence: 99%

“…As a general rule, the blood drawn for laboratory testing should not exceed 5% of the total blood volume per draw; thus, in neonates and infants, a less-than-optimal amount of blood may be available for testing. Approximately 1.5 -4 mL of blood drawn for admission blood test may cause iatrogenic anemia to neonates especially in extremely low birth weight infants [1,2]. Umbilical cord blood (UCB) is remained blood in the placenta and atached umbilical cord after the birth of baby.…”

Section: Introductionmentioning

confidence: 99%

Reference Intervals of Platelets, Lymphocytes and Cardiac Biomarkers in Umbilical Cord Blood

Kim¹,

Hur²,

Moon³

et al. 2017

Umbilical Cord Blood Banking for Clinical Application and Regenerative Medicine

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The umbilical cord blood (UCB) can be used for early detection of neonatal diseases. The UCB can be used for early detection of neonatal diseases. Establishing reference intervals is essential for appropriate interpretation of results of laboratory tests using UCB and for correct medical decisions of pediatricians and neonatologists. The use of proper reference intervals provides reliable information to pediatricians and neonatologists; thus, they could make correct medical decisions for neonates. This chapter discussed reference intervals of platelets, lymphocytes, and cardiac biomarkers in UCB according to the Clinical Laboratory Standards Institute guidelines. Except iatrogenic anemia, thrombocytopenia is the most common hematologic abnormality in neonates. Immature platelet fraction is a novel parameter to estimate megakaryopoiesis and can be useful to understand the mechanism of thrombocytopenia, platelet destruction or bone marrow failure, in neonates. Lymphocyte counts, T cell and B cell, can relect status of immune system in fetus and neonates. Especially Tregs in UCB may contribute to maintain the immune homeostasis in the feto-maternal relationship, and the presence of Tregs would be essential to prevent immune dysregulation in fetus and neonates. Congenital heart disease or defect is the most common birth defect in newborns. Cardiac biomarkers are essential to evaluate heart function and to give information of myocardial injury, necrosis, or myocardial stretch. There are no current guidelines for their routine use in children.

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Umbilical cord blood as a replacement source for admission complete blood count in premature infants

Cited by 60 publications

References 27 publications

Evaluating Otherwise-Discarded Umbilical Cord Blood as a Source for a Neonate’s Complete Blood Cell Count at Various Time Points

Evaluating Otherwise-Discarded Umbilical Cord Blood as a Source for a Neonate’s Complete Blood Cell Count at Various Time Points

Evidence-Based Advances in Transfusion Practice in Neonatal Intensive Care Units

Reference Intervals of Platelets, Lymphocytes and Cardiac Biomarkers in Umbilical Cord Blood

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