新生儿呼吸窘迫综合征的血栓弹力图：一项初步研究。
Thromboelastometry in Neonates with Respiratory Distress Syndrome: A Pilot Study.
作者信息
Katsaras Georgios N, Sokou Rozeta, Tsantes Andreas G, Konstantinidi Aikaterini, Gialamprinou Dimitra, Piovani Daniele, Bonovas Stefanos, Kriebardis Anastasios G, Mitsiakos Georgios, Kokoris Styliani, Tsantes Argirios E
机构信息
Neonatal Intensive Care Unit, Nikaia General Hospital "Aghios Panteleimon", Nikaia, 18454 Piraeus, Greece.
Second Department of Neonatology and Neonatal Intensive Care Unit, Papageorgiou General Hospital, School of Medicine, Aristotle University of Thessaloniki, Nea Efkarpia, 56403 Thessaloniki, Greece.
出版信息
Diagnostics (Basel). 2021 Oct 27;11(11):1995. doi: 10.3390/diagnostics11111995.
BACKGROUND
Although respiratory distress syndrome (RDS) constitutes a postnatal risk factor for bleeding and thromboembolic events in neonates, few studies have addressed this issue. We aimed to evaluate the hemostatic profile of neonates with RDS using rotational thromboelastometry (ROTEM).
METHODS
An observational study was conducted from November 2018 to November 2020 in the NICU of General Hospital of Nikaia "Aghios Panteleimon". Preterm and term neonates with RDS hospitalized in the NICU were included and EXTEM (tissue factor-triggered extrinsic pathway), INTEM (ellagic acid activated intrinsic pathway), and FIBTEM (with platelet inhibitor cytochalasin D) assays were performed at the onset of the disease.
RESULTS
A hypocoagulable profile was noted in neonates with RDS compared to controls, expressed as significant prolongation of EXTEM CT (clotting time) and CFT (clot formation time), lower EXTEM A10 (amplitude at 10 min), MCF (maximum clot firmness), and LI60 (lysis index). Furthermore, prolongation of INTEM CFT and FIBTEM CT, and decreased INTEM and FIBTEM A10 and MCF were found in neonates with RDS. Multivariable logistic regression analysis showed that RDS is an independent factor for the recorded alterations in ROTEM variables.
CONCLUSIONS
RDS is associated with a hypocoagulable profile and greater hyperfibrinolytic potential compared to healthy neonates.
背景
尽管呼吸窘迫综合征（RDS）是新生儿出生后出血和血栓栓塞事件的危险因素，但很少有研究涉及这一问题。我们旨在使用旋转血栓弹力图（ROTEM）评估患有RDS的新生儿的止血情况。
方法
2018年11月至2020年11月在尼凯亚“阿吉奥斯·潘泰莱蒙”综合医院新生儿重症监护病房（NICU）进行了一项观察性研究。纳入在NICU住院的患有RDS的早产儿和足月儿，并在疾病发作时进行EXTEM（组织因子触发的外源性途径）、INTEM（鞣花酸激活的内源性途径）和FIBTEM（使用血小板抑制剂细胞松弛素D）检测。
结果
与对照组相比，患有RDS的新生儿呈现低凝状态，表现为EXTEM CT（凝血时间）和CFT（凝血形成时间）显著延长，EXTEM A10（10分钟时的振幅）、MCF（最大凝血硬度）和LI60（溶解指数）降低。此外，患有RDS的新生儿还出现INTEM CFT和FIBTEM CT延长，以及INTEM和FIBTEM A10及MCF降低。多变量逻辑回归分析表明，RDS是ROTEM变量记录改变的独立因素。
结论
与健康新生儿相比，RDS与低凝状态和更高的纤溶亢进潜力相关。
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