Risk factors and treatments for disseminated intravascular coagulation in neonates.
Birth asphyxia
DIC score
Fresh frozen plasma
Neonates
Recombinant thrombomodulin
Underlying conditions
Journal
Italian journal of pediatrics
ISSN: 1824-7288
Titre abrégé: Ital J Pediatr
Pays: England
ID NLM: 101510759
Informations de publication
Date de publication:
29 Apr 2020
29 Apr 2020
Historique:
received:
08
10
2019
accepted:
06
04
2020
entrez:
1
5
2020
pubmed:
1
5
2020
medline:
26
2
2021
Statut:
epublish
Résumé
Although disseminated intravascular coagulation (DIC) is a critical disease, there is few gold standard interventions in neonatal medicine. The aim of this study is to reveal factors affecting neonatal DIC at birth and to assess the effectiveness of rTM and FFP for DIC in neonates at birth. We retrospectively evaluated DIC score on the first day of life in neonates with underlying conditions associated with DIC. DIC in neonates was diagnosed according to Japan Society of Obstetrical, Gynecological & Neonatal Hematology 2016 neonatal DIC criteria. Comparing neonates with DIC scores of ≥3 (n = 103) to those < 3 (n = 263), SGA, birth asphyxia, low Apgar score, hemangioma, hydrops, PIH, and PA were statistically increased. Among 55 neonates underwent DIC treatment, 53 had birth asphyxia and 12 had intraventricular hemorrhage. Forty-one neonates received FFP or a combination of FFP and antithrombin (FFP group), while 14 neonates received rTM or a combination of rTM, FFP, and antithrombin (rTM group). DIC score before treatment in the rTM group was significantly higher than in the FFP group (4.7 vs 3.6, P < 0.05). After treatment, DIC scores in both groups were significantly reduced on Day 1 and Day 2 (P < 0.05). Among various factors associated with DIC in neonates at birth, birth asphyxia is particularly significant. Furthermore, rTM in combination with FFP therapy was effective for neonatal DIC at birth.
Sections du résumé
BACKGROUND
BACKGROUND
Although disseminated intravascular coagulation (DIC) is a critical disease, there is few gold standard interventions in neonatal medicine. The aim of this study is to reveal factors affecting neonatal DIC at birth and to assess the effectiveness of rTM and FFP for DIC in neonates at birth.
METHODS
METHODS
We retrospectively evaluated DIC score on the first day of life in neonates with underlying conditions associated with DIC. DIC in neonates was diagnosed according to Japan Society of Obstetrical, Gynecological & Neonatal Hematology 2016 neonatal DIC criteria.
RESULTS
RESULTS
Comparing neonates with DIC scores of ≥3 (n = 103) to those < 3 (n = 263), SGA, birth asphyxia, low Apgar score, hemangioma, hydrops, PIH, and PA were statistically increased. Among 55 neonates underwent DIC treatment, 53 had birth asphyxia and 12 had intraventricular hemorrhage. Forty-one neonates received FFP or a combination of FFP and antithrombin (FFP group), while 14 neonates received rTM or a combination of rTM, FFP, and antithrombin (rTM group). DIC score before treatment in the rTM group was significantly higher than in the FFP group (4.7 vs 3.6, P < 0.05). After treatment, DIC scores in both groups were significantly reduced on Day 1 and Day 2 (P < 0.05).
CONCLUSIONS
CONCLUSIONS
Among various factors associated with DIC in neonates at birth, birth asphyxia is particularly significant. Furthermore, rTM in combination with FFP therapy was effective for neonatal DIC at birth.
Identifiants
pubmed: 32349778
doi: 10.1186/s13052-020-0815-7
pii: 10.1186/s13052-020-0815-7
pmc: PMC7191786
doi:
Substances chimiques
Thrombomodulin
0
Types de publication
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Pagination
54Références
Pediatr Res. 1979 Dec;13(12):1330-5
pubmed: 523193
Thromb Haemost. 1995 Sep;74(3):848-52
pubmed: 8571309
N Engl J Med. 2005 Oct 13;353(15):1574-84
pubmed: 16221780
BMJ Open. 2017 Feb 09;7(2):e013787
pubmed: 28183808
Thromb Haemost. 2016 Jun 2;115(6):1157-66
pubmed: 26939575
Indian J Hematol Blood Transfus. 2017 Jun;33(2):195-199
pubmed: 28596650
Am J Hematol. 1993 Jul;43(3):190-4
pubmed: 8352234
Semin Thromb Hemost. 2010 Jun;36(4):419-28
pubmed: 20614393
Lancet. 2005 Feb 19-25;365(9460):663-70
pubmed: 15721471
Transfus Med Rev. 2016 Oct;30(4):174-82
pubmed: 27473518
BMC Pediatr. 2014 Nov 03;14:277
pubmed: 25367591
J Crit Care. 2016 Dec;36:29-34
pubmed: 27546744
Crit Care. 2017 Aug 22;21(1):219
pubmed: 28826407
N Engl J Med. 2009 Oct 1;361(14):1349-58
pubmed: 19797281
J Matern Fetal Neonatal Med. 2016 Dec;29(24):4096-100
pubmed: 26952582
Eur J Pediatr. 2014 Mar;173(3):303-11
pubmed: 24005342
Clin Appl Thromb Hemost. 2014 Jul;20(5):465-72
pubmed: 24563247
Haematologica. 2005 Mar;90(3):419-21
pubmed: 15749684
J Perinatol. 2012 Nov;32(11):869-73
pubmed: 22157628
Am J Perinatol. 2019 Dec;36(14):1464-1470
pubmed: 30703808
Thromb Res. 2015 May;135(5):897-901
pubmed: 25784136
J Matern Fetal Neonatal Med. 2011 Oct;24 Suppl 1:129-31
pubmed: 21942611
Ann Intensive Care. 2017 Nov 2;7(1):110
pubmed: 29098447
Thromb Res. 2011 Aug;128(2):186-90
pubmed: 21429565
Semin Thromb Hemost. 1998;24(5):463-6
pubmed: 9834014
Arch Dis Child Fetal Neonatal Ed. 2003 Jul;88(4):F319-23
pubmed: 12819166
Crit Care. 2013 Dec 16;17(6):R297
pubmed: 24342495
Pediatrics. 2018 Aug;142(2):
pubmed: 30002139