Emoke Deschmann1, Martha Sola-Visner2, Matthew A Saxonhouse3. 1. Division of Newborn Medicine, Boston Children's Hospital and Harvard Medical School, Boston, MA; Division of Neonatology, Department of Women's and Children's Health, Karolinska Institutet, Stockholm, Sweden. 2. Division of Newborn Medicine, Boston Children's Hospital and Harvard Medical School, Boston, MA. 3. Division of Neonatology, Department of Pediatrics, University of Florida College of Medicine, Gainesville, FL; Department of Pediatrics, Levine Children's Hospital/Jeff Gordon Children's Hospital, Carolinas Healthcare System, Concord, NC.
Abstract
OBJECTIVE: To evaluate the relationship between platelet counts and the platelet function analyzer-100 closure times (CTs) in neonates with thrombocytopenia, and to determine what other factors significantly affect CTs. STUDY DESIGN: In a single institution prospective cross-sectional study, blood samples from neonates with platelet counts <150 × 10(9)/L were tested on the platelet function analyzer-100 with CT-collagen/epinephrine (CT-Epi) and CT-collagen/adenosine diphosphate (CT-ADP) cartridges. RESULTS: The mean platelet count was 95 ± 28 × 10(9)/L for 48 infants with a mean gestational age 30.9 ± 5.3 weeks and median postnatal age of 5 (3-18) days. No association was evident between CT-Epi and platelet count. However, the CT-ADP was prolonged in many (but not all) infants with platelet counts <90 × 10(9)/L. Among infants <32 weeks gestational age, we found a moderate negative correlation between CT-ADP and platelet count (r = -0.54, P = .0045). The negative correlation was strongest in infants <32 weeks and <10 days old (r = -0.8, P = .0017). Other variables examined (hematocrit, infection, Score of Neonatal Acute Physiology II) did not have a significant effect on CT-ADP in a linear regression model. CONCLUSIONS: Platelet counts <90 × 10(9)/L are associated with prolonged CT-ADP times in some but not all infants. Gestational and postnatal age-related differences in platelet function account for some of this variability. The predictive value of CT-ADP on neonatal bleeding risk remains to be studied.
OBJECTIVE: To evaluate the relationship between platelet counts and the platelet function analyzer-100 closure times (CTs) in neonates with thrombocytopenia, and to determine what other factors significantly affect CTs. STUDY DESIGN: In a single institution prospective cross-sectional study, blood samples from neonates with platelet counts <150 × 10(9)/L were tested on the platelet function analyzer-100 with CT-collagen/epinephrine (CT-Epi) and CT-collagen/adenosine diphosphate (CT-ADP) cartridges. RESULTS: The mean platelet count was 95 ± 28 × 10(9)/L for 48 infants with a mean gestational age 30.9 ± 5.3 weeks and median postnatal age of 5 (3-18) days. No association was evident between CT-Epi and platelet count. However, the CT-ADP was prolonged in many (but not all) infants with platelet counts <90 × 10(9)/L. Among infants <32 weeks gestational age, we found a moderate negative correlation between CT-ADP and platelet count (r = -0.54, P = .0045). The negative correlation was strongest in infants <32 weeks and <10 days old (r = -0.8, P = .0017). Other variables examined (hematocrit, infection, Score of Neonatal Acute Physiology II) did not have a significant effect on CT-ADP in a linear regression model. CONCLUSIONS: Platelet counts <90 × 10(9)/L are associated with prolonged CT-ADP times in some but not all infants. Gestational and postnatal age-related differences in platelet function account for some of this variability. The predictive value of CT-ADP on neonatal bleeding risk remains to be studied.
Authors: Emoke Deschmann; Matthew A Saxonhouse; Henry A Feldman; Mikael Norman; Maria Barbian; Martha Sola-Visner Journal: JAMA Pediatr Date: 2019-04-01 Impact factor: 16.193
Authors: Pablo Cure; Melania Bembea; Stella Chou; Allan Doctor; Anne Eder; Jeanne Hendrickson; Cassandra D Josephson; Alan E Mast; William Savage; Martha Sola-Visner; Philip Spinella; Simon Stanworth; Marie Steiner; Traci Mondoro; Shimian Zou; Catherine Levy; Myron Waclawiw; Nahed El Kassar; Simone Glynn; Naomi L C Luban Journal: Transfusion Date: 2017-03-28 Impact factor: 3.157