The Effect of Severe Birth Asphyxia on the Hemostasis System in Newborns During the First Hour of Life

Голуб, И. Е.; Zarubin, A A; Михеева, Н. И.; Ваняркина, А. С.; Иванова, О. Г.

doi:10.15360/1813-9779-2017-1-17-23

Cited by 5 publications

(2 citation statements)

References 2 publications

(8 reference statements)

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“…This study also described lower values of coagulation factors V and VIII in some asphyxiated neonates, as well as increased FDPs, implying a higher frequency of DIC in this group. Golub et al, 41 using TEG in asphyxiated and healthy term neonates from blood extracted within the first hour of life, reported that asphyxiated newborns had prolonged R and K and reduced α-angle and MA, findings compatible with a hypocoagulable profile in this group. Hathaway et al 42 performed coagulation testing on cord blood in neonates of high-risk pregnancies and reported that though infants with fetal distress had increased levels of factors V and VIII, they were not hypercoagulable; R + K parameter and antithrombin were within normal limits.…”

Section: Resultsmentioning

confidence: 87%

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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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Section: Resultsmentioning

confidence: 87%

“…Thieme. All rights reserved 41. using TEG in asphyxiated and healthy term neonates from blood extracted within the first hour of life, reported that asphyxiated newborns had prolonged R and K and reduced α-angle and MA, findings compatible with a hypocoagulable profile in this group.…”

mentioning

confidence: 85%

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

Tsaousi

Iliodromiti

Iacovidou

et al. 2022

Semin Thromb Hemost

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Pathogenesis, Prognosis and Outcomes of Multiple Organ Failure in Newborns (Review)

Golomidov¹,

Grigoriev

Moses

et al. 2022

Obŝaâ reanimatologiâ

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Multiple organ failure (MOF) is the leading cause of neonatal mortality in intensive care units. The prevalence of MOF in newborns is currently unclear, since its incidence varies in asphyxia, sepsis, prematurity, and comorbidity, and depends on the level of development and funding of health care in different countries. Sepsis and acute respiratory distress syndrome prevail among the causes of MOF in this category of patients.Aim of the review. To summarize the available literature data on the pathogenesis, therapeutic strategies and outcomes of MOF in newborns.Material and methods. We searched PubMed, Scopus, Web of Science, and RSCI databases using the following keywords: «newborns, multiple organ failure, etiology, pathogenesis, premature, diagnosis, treatment, respiratory support, cardiotonic support», without language limitations. A total of 144 full-text sources were selected for analysis, 70% of which were published in the last five years and 50% were published in the last three years. Criteria for exclusion were low information value and outdated data.Results. The prevalence of MOF in neonates is currently unclear. This could be due to common association of neonatal MOF (as well as the adult one) with various diseases; thus, its incidence is not the same for asphyxia, sepsis, prematurity, and comorbidities. There is no precise data on neonatal mortality in MOF, but according to some reports, it may be as high as 13-50%.In newborns, MOF can be caused by two major causes, intrapartum/postnatal asphyxia and sepsis, but could also be influenced by other intranatal factors such as intrauterine infections and acute interruption of placental blood flow.The key element in the pathogenesis of neonate MOF is cytokinemia, which triggers universal critical pathways. Attempts to identify different clinical trajectories of critical illness in various categories of patients have led to the discovery of MOF phenotypes with specific patterns of systemic inflammatory response. This scientific trend is very promising for the creation of new classes of drugs and individual therapeutic pathways in neonates with MOF of various etiologies.The pSOFA scale is used to predict the outcome of neonatal MOF, however, the nSOFA scale has higher validity in premature infants with low birth weight.Central nervous system damage is the major MOF-associated adverse outcome in newborns, with gestational age and the timing of treatment initiation being key factors affecting risk of MOF development in both full-term and premature infants.Conclusion. The study of cellular messengers of inflammation, MOF phenotypes, mitochondrial insufficiency, and immunity in critically ill infants with MOF of various etiologies is a promising area of research. The pSOFA scale is suggested for predicting the outcome of MOF in full-term infants, while the nSOFA scale should be used in premature infants with low birth weight.

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Diagnostic and prognostic value of aEEG in newborns aged of 24 hours of life with hypoxic-ischemic encephalopathy

Zadvornov¹,

Golomidov²,

Grigoriev³

et al. 2018

Anesteziologiya I Reanimatologiya

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Цель исследования-оценить диагностическое и прогностическое значение амплитудно-интегрированной электроэнцефалографии (АЭЭГ) у доношенных новорожденных с гипоксически-ишемической энцефалопатией (ГИЭ), получающих психотропные препараты. Материал и методы. В исследование включены 50 новорожденных с ГИЭ различной тяжести, которых разделили на две группы. В исследуемую группу вошли 28 новорожденных, имеющих в возрасте 24 ч жизни патологические паттерны АЭЭГ; в контрольную группу-22 новорожденных, имеющих в возрасте 24 ч жизни нормальные паттерны АЭЭГ. В возрасте 24 ч жизни начато проведение АЭЭГ новорожденным обеих групп. Сравнивали морфологические, неврологические, лабораторные данные, а также показатели исхода заболевания. Оценивали значение АЭЭГ в установлении диагноза ГИЭ и прогнозировании неврологического исхода. Результаты. У новорожденных исследуемой группы чаще наблюдались брадикардия при рождении, метаболический ацидоз, угнетение ЦНС, судорожный синдром, при котором применяли антиконвульсанты, отек головного мозга в 1-е дни жизни. Отмечена большая продолжительность искусственной вентиляции легких у новорожденных исследуемой группы, а также большая длительность пребывания в отделении реанимации и интенсивной терапии. При выписке у новорожденных исследуемой группы чаще, чем у новорожденных контрольной группы, наблюдались судорожный синдром, бульбарные расстройства и атрофические изменения головного мозга. Суточная АЭЭГ имела чувствительность 87%, специфичность 70%, предиктивную ценность положительного результата 71% и отрицательного-86%. Показатели отношения правдоподобия положительного результата в возрасте 24, 36 и 48 ч жизни составили 2,9, 3,1 и 7,6 соответственно. Заключение. У новорожденных с ГИЭ, имеющих в возрасте 24 ч жизни патологические паттерны АЭЭГ, отмечено более тяжелое поражение головного мозга и неблагоприятный неврологический исход. Наибольшее отношение правдоподобия положительного результата наблюдалось в возрасте 48 ч жизни. Глубина угнетения электрокортикальной активности при применении психотропных препаратов зависит, вероятно, от тяжести поражения ЦНС. Ключевые слова: гипоксически-ишемическая энцефалопатия; амплитудно-интегрированная электроэнцефалография; церебральная недостаточность; судороги.

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The Effect of Severe Birth Asphyxia on the Hemostasis System in Newborns During the First Hour of Life

Cited by 5 publications

References 2 publications

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

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

Pathogenesis, Prognosis and Outcomes of Multiple Organ Failure in Newborns (Review)

Diagnostic and prognostic value of aEEG in newborns aged of 24 hours of life with hypoxic-ischemic encephalopathy

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