Fresh frozen plasma transfusion in the neonatal population: A systematic review

Sokou, Rozeta; Parastatidou, Stavroula; Konstantinidi, Aikaterini; Tsantes, Andreas G.; Iacovidou, Nicoletta; Doxani, Chrysoula; Piovani, Daniele; Bonovas, Stefanos; Stefanidis, Ioannis; Ζιντζαράς, Ηλίας; Tsantes, Argirios Ε.

doi:10.1016/j.blre.2022.100951

Cited by 15 publications

(39 citation statements)

References 74 publications

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“…Consumption of coagulation factors and platelets, as well as reduced platelet functionality in septic patients is associated with increased risk of bleeding ( 4 ). Prompt diagnosis and management of hemostatic disorders in neonates with sepsis is essential for optimizing care of these patients ( 47 ). Conventional coagulation tests, including prothrombin time (PT) and activated partial thromboplastin time (aPTT), and platelet count, present limitations in the evaluation of the global hemostatic profile ( 48 ).…”

Section: Discussionmentioning

confidence: 99%

Development and validation of a sepsis diagnostic scoring model for neonates with suspected sepsis

et al. 2022

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BackgroundWe aimed to develop and validate a diagnostic model for sepsis among neonates evaluated for suspected sepsis, by incorporating thromboelastometry parameters, maternal/neonatal risk factors, clinical signs/symptoms and laboratory results.MethodsThis retrospective cohort study included 291 neonates with presumed sepsis, hospitalized in a NICU, from 07/2014 to 07/2021. Laboratory tests were obtained on disease onset and prior to initiating antibiotic therapy. Τhromboelastometry extrinsically activated (EXTEM) assay was performed simultaneously and Tοllner and nSOFA scores were calculated. Sepsis diagnosis was the outcome variable. A 10-fold cross-validation least absolute shrinkage and selection operator logit regression procedure was applied to derive the final multivariable score. Clinical utility was evaluated by decision curve analysis.ResultsGestational age, CRP, considerable skin discoloration, liver enlargement, neutrophil left shift, and EXTEM A10, were identified as the strongest predictors and included in the Neonatal Sepsis Diagnostic (NeoSeD) model. NeoSeD score demonstrated excellent discrimination capacity for sepsis and septic shock with an AUC: 0.918 (95% CI, 0.884–0.952) and 0.974 (95% CI, 0.958–0.989) respectively, which was significantly higher compared to Töllner and nSOFA scores.ConclusionsThe NeoSeD score is simple, accurate, practical, and may contribute to a timely diagnosis of sepsis in neonates with suspected sepsis. External validation in multinational cohorts is necessary before clinical application.

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Section: Discussionmentioning

confidence: 99%

Development and validation of a sepsis diagnostic scoring model for neonates with suspected sepsis

et al. 2022

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“…As a result, it seems that their use as a guide to transfusion of blood products could lead to significant decrease in neonatal mortality and morbidity. 62…”

Section: Discussionmentioning

confidence: 99%

Hemostasis in Neonates with Perinatal Hypoxia—Laboratory Approach: A Systematic Review

Tsaousi

Iliodromiti

Iacovidou

et al. 2022

Semin Thromb Hemost

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Birth asphyxia, with an estimated prevalence of 1 to 6 per 1,000 live births, may lead to multiorgan dysfunction due to impaired oxygen and/or blood supply to various organ systems, including the hemostatic system. Coagulopathy, a common complication of perinatal asphyxia, has been described since the 1960s. The aim of this study was to systematically review the literature for records on the use of hemostasis tests in the evaluation of coagulation disorders, in neonates who had suffered from perinatal hypoxia or asphyxia. We identified published studies by searching PubMed and Scopus, up until April 2022. The literature search retrieved 37 articles fulfilling the inclusion criteria of the review. According to the bibliography, thrombocytopenia is commonly associated with perinatal hypoxia/asphyxia. The thrombocytopenia is usually described as mild and platelets return to normal levels by the 10th day of life. Additionally, hypoxic neonates usually present with a hypocoagulable profile, as reflected by the prolongation of standard coagulation tests, including prothrombin time, activated partial thromboplastin time, and international normalized ratio, findings commonly associated with disseminated intravascular coagulation, and by the reduction of the levels of the physiologic inhibition of coagulation system. A few studies thus far using ROTEM/TEG in hypoxic neonates have come to the same conclusion as well; hypoxic newborns seem to be characterized by a hypocoagulable profile compared with healthy neonates. It should be emphasized, however, that standard coagulation tests provide only a rough estimation of the true bleeding or thrombotic risk of hypoxic neonates. On the contrary, viscoelastic methods seem to be more precise in the early detection of hemostasis disorders in the neonatal population. However, until now, there was uncertainty as to the most appropriate coagulation assays for diagnosis and management of coagulation derangement in neonates with perinatal hypoxia indicating the need for further research on this field.

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“…Since the premature neonate has a small total blood volume, it cannot easily compensate the hypovolemia, and falls easily into shock. Thus, prompt detection, timely intervention and appropriate management of the causes of a hemorrhage are decisive for its efficient control and patient prognosis [ 53 ]. The above-mentioned factors analyzed individually to each case, could lead to a possible time-related association between the technical manipulation and the development of the SHL.…”

Section: Discussionmentioning

confidence: 99%

Subcapsular Liver Hematoma—A Life-Threatening Condition in Preterm Neonates—A Case Series and Systematic Review of the Literature

Liakou

Batsiou

Konstantinidi

et al. 2022

JCM

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The subcapsular hematoma (SLH) of the liver is a rare finding in living infants. The clinical presentation of rupture is non-specific, with the signs of hypovolemic shock dominating. The causes are several, with prematurity, trauma and sepsis playing a leading role in the creation of an SHL. Umbilical vein catheterization and an increased bleeding tendency have also been associated with this usually fatal diagnosis. Abdominal ultrasonography, among other imaging methods, comprises the gold standard examination for early diagnosis. It should be differentiated from other possible causes of shock, such as sepsis and intraventricular hemorrhage, which have similar clinical presentation. We report a case series of three very low birth weight preterms (VLBW), with an SHL, during the first days of life, one of which survived from this usually catastrophic condition. A comprehensive review of the literature regarding this clinical entity was also conducted. A high index of suspicion is essential for early identification of such a case, with conservative or surgical treatment being the way to go.

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Fresh frozen plasma transfusion in the neonatal population: A systematic review

Cited by 15 publications

References 74 publications

Development and validation of a sepsis diagnostic scoring model for neonates with suspected sepsis

Development and validation of a sepsis diagnostic scoring model for neonates with suspected sepsis

Hemostasis in Neonates with Perinatal Hypoxia—Laboratory Approach: A Systematic Review

Subcapsular Liver Hematoma—A Life-Threatening Condition in Preterm Neonates—A Case Series and Systematic Review of the Literature

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