Capecchi Ester, Cortesi Valeria, Raffaeli Genny, Picciolli Irene, Pesenti Nicola, Fumagalli Monica, Cavallaro Giacomo, Ghirardello Stefano, Francescato Gaia
Neonatal Intensive Care Unit, ASST Grande Ospedale Metropolitano Niguarda, Milan, Italy.
Neonatal Intensive Care Unit, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy.
Blood Transfus. 2025 May-Jun;23(3):255-265. doi: 10.2450/BloodTransfus.765. Epub 2024 Oct 25.
Newborns exhibit a pro-coagulant hemostatic profile despite platelet hyporeactivity and reduced coagulation factors. Assessing infant hemostasis, particularly in preterm infants, is challenging, with inconsistent findings regarding the relationship between platelet count and function in patients with patent ductus arteriosus (PDA).
This study aims to assess platelet function using the Total Thrombus-Formation Analysis System (T-TAS®01) in term and preterm newborns. T-TAS®01 measures the Occlusion Start Time (OST), Occlusion Time (OT), and the Area Under the Curve (AUC) at the end of thrombus formation. The study includes term and preterm newborns below 30 weeks' gestational age (GA) admitted to the Neonatal Intensive Care Unit. Blood samples were collected from preterm newborns on the 1 day of life (T0), between 48-72 hours of life (T1), between the 7 and 10 day of life (T2), and from term newborns at T0 and T2. Secondary endpoints include the relationship between T-TAS®01 parameters and significant PDA in preterm newborns and the correlation between T-TAS®01 parameters, GA, and complete blood count (CBC).
OST is delayed by 65.5 seconds in preterm infants at T0 (p<0.001) and by 46 seconds at T2 (p=0.041) compared to full-term newborns. OT is delayed by 164 seconds in preterm infants at T0 (p=0.002) and by 352 seconds at T2 (p=0.002). AUC at T0 is lower in preterm infants (p=0.028). There is no significant correlation between T-TAS®01 parameters and GA or CBC. Additionally, OST and OT are delayed, and AUC is reduced in preterm infants with PDA and hemodynamically significant PDA (hsPDA).
T-TAS®01 is a reliable tool for evaluating platelet function in term newborns. However, measurements show higher variability in preterm infants, with significantly lower platelet activity observed in preterm infants with PDA and hsPDA.
尽管新生儿血小板反应性低下且凝血因子减少，但仍表现出促凝血的止血特征。评估婴儿的止血功能，尤其是早产儿，具有挑战性，关于动脉导管未闭（PDA）患者血小板计数与功能之间的关系，研究结果并不一致。
本研究旨在使用全血栓形成分析系统（T-TAS®01）评估足月儿和早产儿的血小板功能。T-TAS®01可测量血栓形成结束时的闭塞开始时间（OST）、闭塞时间（OT）和曲线下面积（AUC）。该研究纳入了入住新生儿重症监护病房的孕周小于30周的足月儿和早产儿。在出生第1天（T0）、出生48 - 72小时（T1）、出生第7至10天（T2）采集早产儿血样，并在T0和T2采集足月儿血样。次要终点包括T-TAS®01参数与早产儿显著PDA之间的关系，以及T-TAS®01参数、孕周和全血细胞计数（CBC）之间的相关性。
与足月儿相比，早产儿在T0时OST延迟65.5秒（p<0.001），在T2时延迟46秒（p = 0.041）。早产儿在T0时OT延迟164秒（p = 0.002），在T2时延迟352秒（p = 0.002）。早产儿在T0时的AUC较低（p = 0.028）。T-TAS®01参数与孕周或CBC之间无显著相关性。此外，患有PDA和血流动力学显著PDA（hsPDA）的早产儿的OST和OT延迟，AUC降低。
T-TAS®01是评估足月儿血小板功能的可靠工具。然而，测量结果显示早产儿的变异性更高，患有PDA和hsPDA的早产儿的血小板活性显著降低。
