Useful Platelet Indices for the Diagnosis and Follow-Up of Patent Ductus Arteriosus

Kazancı, Elif Güler; Büyüktiryaki, Mehmet; Ünsal, Handan; Tayman, Cüneyt

doi:10.1055/s-0039-1688821

Cited by 14 publications

(17 citation statements)

References 39 publications

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“…Echtler et al identified that platelets were recruited to contract DA within minutes after birth, initiate thrombotic occlusion of DA, and support subsequent anatomical reorganization (68). MPV and PDW are non-significant in predicting PDA in our results despite the statement that they are markers reflecting platelet activity (33,71).…”

Section: Discussioncontrasting

confidence: 71%

Related Factors of Patent Ductus Arteriosus in Preterm Infants: A Systematic Review and Meta-Analysis

Liu

Zhu

et al. 2021

Front. Pediatr.

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Background: Patent ductus arteriosus (PDA) is a dramatically harmful disease in the neonatal period, in particular common in preterm infants, and our study was to determine related factors of PDA in preterm infants.Methods: A comprehensive literature review was conducted in PubMed, EMBASE, and Web of Science. The pooled odds ratio and standard mean difference were calculated to compare dichotomous and continuous variables, respectively. In addition, we also assessed the heterogeneity and publication bias and carried out sensitivity analysis for each related factor.Results: We included 45 studies with 87,419 individuals. After the primary analysis and a series of adjustments, results showed chorioamnionitis, lower gestational age, lower birth weight, bronchopulmonary dysplasia, intraventricular hemorrhage, necrotizing enterocolitis, respiratory distress syndrome, sepsis, surfactant treatment, ventilation, and lower platelet count had a positive correlation with PDA, while small for gestational age decreased the incidence of PDA in preterm infants. Besides, premature rupture of membranes, preeclampsia, antenatal steroids, male gender, mean platelet volume, and platelet distribution width were found to have no statistically significant relationship with PDA.Conclusion: Preterm infants with more immature characteristics generally have a higher likelihood to develop PDA. The prevention, diagnosis, and management of PDA may depend on these results, and effective measures can be taken accordingly.

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Section: Discussioncontrasting

confidence: 71%

Related Factors of Patent Ductus Arteriosus in Preterm Infants: A Systematic Review and Meta-Analysis

Liu

Zhu

et al. 2021

Front. Pediatr.

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“…In mice, platelet-triggered ductal sealing was shown to be a relevant mechanism for ductal closure [4]. In this respect, the role of platelets has been explored in preterm infants, but conclusions have been conflicting [5][6][7][8][9]. A meta-analysis observed an association between a platelet count of < 100,000/µL and DA patency [10].…”

Section: Discussionmentioning

confidence: 99%

“…Therefore the ability of platelet count to predict spontaneous DA closure or response to pharmacological treatment in preterm newborns has been explored, but results are conflicting [5][6][7][8][9]. A meta-analysis confirmed a marginal but significant association between a platelet count of < 100,000/µL and hsPDA [10].…”

Section: Introductionmentioning

confidence: 99%

The Thromboelastographic Profile at Birth in Very Preterm Newborns with Patent Ductus Arteriosus

et al. 2020

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Background: The role of hemostasis in the closure of patent ductus arteriosus (PDA) in preterm infants is controversial. Objective: To assess thromboelastography (TEG) at birth in very-low-birth-weight (VLBW) infants affected by PDA. Methods: This was an ancillary study of a prospective observational study aimed at defining the TEG profile in healthy VLBW infants in the first month of life. In this analysis, we included neonates of < 33 weeks' gestational age (GA) with PDA and compared TEG traces based on (1) spontaneous closure versus the need for pharmacological treatment and (2) treatment response. We collected blood samples in the 1st day of life to perform recalcified native-blood TEG (reaction time, maximum amplitude, and lysis at 30 min [Ly30)]), standard coagulation tests, and a full blood count. Results: We enrolled 151 infants with a PDA at the first echocardiogram; 111 experienced spontaneous PDA closure while 40 required treatment. Mean GA was 29.7 ± 1.7 and 27.6 ± 2.1 weeks, and birth weight was 1,158 ± 256 and 933 ± 263 g in the 2 groups, respectively (p < 0.001). The hemostatic profile was similar between groups. Median hematocrit (44.6 and 48.7%; p = 0.01) and platelet count (187 and 216 × 10 3 /μL; p = 0.04) were lower in the treated group, although differences lost significance after controlling for GA and illness severity in the multivariate analysis. Responders to PDA treatment (n = 20) had a significantly lower median Ly30 than nonresponders (0 and 0.7%; p = 0.02). Conclusion: TEG at birth does not predict spontaneous PDA closure in preterm newborns. Fibrinolysis is enhanced in nonresponders to PDA treatment; this observation warrants further investigation.

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“…Another group from Turkey did not find any relationship between platelet counts, MPV, or platelet mass and successful hsPDA closure by ibuprofen (19). In addition to MPV, PDW, and platelet mass, other hematologic indices, such as red cell distribution width-to-platelet ratio (RPR) and platelet-to-lymphocyte-ratio (PLR) have been proposed as markers for hsPDA and treatment response (31)(32)(33).…”

Section: Platelet Indices and Pdamentioning

confidence: 99%

Current Controversy on Platelets and Patent Ductus Arteriosus Closure in Preterm Infants

et al. 2021

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Platelets are critically involved in murine patent ductus arteriosus (PDA) closure. To date, the clinical significance of these findings in human preterm infants with PDA is still controversial. We discuss the available study data on the role of platelets for PDA closure in preterm infants: Several mostly retrospective studies have yielded conflicting results on whether thrombocytopenia contributes to failed spontaneous ductal closure. The same applies to investigations on the role of thrombocytopenia as a risk factor for unsuccessful ductus arteriosus closure by pharmacological treatment with cyclooxygenase inhibitors. Nonetheless, recent meta-analyses have concluded that thrombocytopenia constitutes an independent risk factor for both failed spontaneous and pharmacological PDA closure in preterm infants. However, the available investigations differ in regard to patient characteristics, diagnostic strategies, and treatment protocols. Several studies suggest that impaired platelet function rather than platelet number is critically involved in failure of ductus arteriosus closure in the preterm infant. A recent randomized-controlled trial on platelet transfusions in preterm infants with PDA failed to show any benefit for liberal vs. restrictive transfusion thresholds on PDA closure rates. Importantly, liberal transfusions were associated with an increased rate of intraventricular hemorrhage, and thus should be avoided. In conclusion, the available evidence suggests that thrombocytopenia and platelet dysfunction contribute to failure of spontaneous and pharmacological PDA closure in preterm infants. However, these platelet effects on PDA seem to be of only moderate clinical significance. Furthermore, platelet transfusions in thrombocytopenic preterm infants in order to facilitate PDA closure appear to cause more harm than good.

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Useful Platelet Indices for the Diagnosis and Follow-Up of Patent Ductus Arteriosus

Cited by 14 publications

References 39 publications

Related Factors of Patent Ductus Arteriosus in Preterm Infants: A Systematic Review and Meta-Analysis

Related Factors of Patent Ductus Arteriosus in Preterm Infants: A Systematic Review and Meta-Analysis

The Thromboelastographic Profile at Birth in Very Preterm Newborns with Patent Ductus Arteriosus

Current Controversy on Platelets and Patent Ductus Arteriosus Closure in Preterm Infants

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