Fresh frozen plasma reduces thrombin formation in newborn infants
Background: Newborn infants undergoing intensive care are at risk of bleeding and thrombotic complications. Fresh frozen plasma (FFP) is used in hope of preventing these complications, despite poorly defined effects on the coagulation system and lack of proven clinical efficacy. Objectives and metho...
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| Veröffentlicht in: | Journal of thrombosis and haemostasis 2003-06, Vol.1 (6), p.1189-1194 |
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| container_title | Journal of thrombosis and haemostasis |
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| creator | Hyytiäinen, S. Syrjälä, M. Fellman, V. Heikinheimo, M. Petäjä, J. |
| description | Background: Newborn infants undergoing intensive care are at risk of bleeding and thrombotic complications. Fresh frozen plasma (FFP) is used in hope of preventing these complications, despite poorly defined effects on the coagulation system and lack of proven clinical efficacy. Objectives and methods: We prospectively evaluated coagulopathy and the effect of standardized amount of FFP transfusion (10 mL kg−1 + 4 mL in 2 h) on various coagulation markers in 33 newborn infants during the first 24 h of intensive care. Results: Increased levels of prothrombin fragment F1+2, thrombin–antithrombin complexes (TAT), and d‐dimer were found prior to the transfusion in 97%, 81%, and 100% of the patients, respectively. FFP transfusion was associated with a decrease in F1+2 level in 26/32 (81%) of the patients. The extent of F1+2 decrease correlated with the pretransfusion F1+2 level (R = 0.65, P |
| doi_str_mv | 10.1046/j.1538-7836.2003.00243.x |
| format | Article |
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Fresh frozen plasma (FFP) is used in hope of preventing these complications, despite poorly defined effects on the coagulation system and lack of proven clinical efficacy. Objectives and methods: We prospectively evaluated coagulopathy and the effect of standardized amount of FFP transfusion (10 mL kg−1 + 4 mL in 2 h) on various coagulation markers in 33 newborn infants during the first 24 h of intensive care. Results: Increased levels of prothrombin fragment F1+2, thrombin–antithrombin complexes (TAT), and d‐dimer were found prior to the transfusion in 97%, 81%, and 100% of the patients, respectively. FFP transfusion was associated with a decrease in F1+2 level in 26/32 (81%) of the patients. The extent of F1+2 decrease correlated with the pretransfusion F1+2 level (R = 0.65, P < 0.0001). The patient series was divided into two groups according to increasing pretransfusional F1+2 level: Group 1 (preFFP F1+2 ≥ 2.35 nm, n = 16), Group 2 (F1+2 <2.35 nm, n = 16). In Group 1, F1+2 decreased on average 1.58 nm (P < 0.01) from the baseline during FFP transfusion but no significant change in the level of F1+2 during the transfusion was observed in Group 2. Pretransfusional levels of individual factors or prothrombin time (PT) did not correlate with the FFP‐associated decrease in F1+2 level. Conclusions: In the patients with the highest pretransfusional thrombin formation, FFP had an acute thrombin‐reducing effect. Pretransfusion thrombin generation markers, rather than PT or individual pro‐ and anticoagulants, may be helpful in identifying the patient who will have measurable coagulational effects induced by FFP.</description><identifier>ISSN: 1538-7933</identifier><identifier>ISSN: 1538-7836</identifier><identifier>EISSN: 1538-7836</identifier><identifier>DOI: 10.1046/j.1538-7836.2003.00243.x</identifier><identifier>PMID: 12871318</identifier><language>eng</language><publisher>Oxford, UK: Blackwell Science Inc</publisher><subject>Biomarkers - blood ; Blood Coagulation ; Female ; fresh frozen plasma ; Hemorrhage - etiology ; Hemorrhage - prevention & control ; Humans ; Infant, Newborn ; Male ; newborn ; Plasma ; Prospective Studies ; protein C ; thrombin ; Thrombin - biosynthesis ; Thrombophilia - complications ; Thrombophilia - prevention & control ; Thrombosis - complications ; Thrombosis - prevention & control</subject><ispartof>Journal of thrombosis and haemostasis, 2003-06, Vol.1 (6), p.1189-1194</ispartof><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c4163-6ce0a6477576bca721f982bea71b504f63356db27e92879fafb62d901b961e9f3</citedby><cites>FETCH-LOGICAL-c4163-6ce0a6477576bca721f982bea71b504f63356db27e92879fafb62d901b961e9f3</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><link.rule.ids>314,776,780,27901,27902</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/12871318$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Hyytiäinen, S.</creatorcontrib><creatorcontrib>Syrjälä, M.</creatorcontrib><creatorcontrib>Fellman, V.</creatorcontrib><creatorcontrib>Heikinheimo, M.</creatorcontrib><creatorcontrib>Petäjä, J.</creatorcontrib><title>Fresh frozen plasma reduces thrombin formation in newborn infants</title><title>Journal of thrombosis and haemostasis</title><addtitle>J Thromb Haemost</addtitle><description>Background: Newborn infants undergoing intensive care are at risk of bleeding and thrombotic complications. Fresh frozen plasma (FFP) is used in hope of preventing these complications, despite poorly defined effects on the coagulation system and lack of proven clinical efficacy. Objectives and methods: We prospectively evaluated coagulopathy and the effect of standardized amount of FFP transfusion (10 mL kg−1 + 4 mL in 2 h) on various coagulation markers in 33 newborn infants during the first 24 h of intensive care. Results: Increased levels of prothrombin fragment F1+2, thrombin–antithrombin complexes (TAT), and d‐dimer were found prior to the transfusion in 97%, 81%, and 100% of the patients, respectively. FFP transfusion was associated with a decrease in F1+2 level in 26/32 (81%) of the patients. The extent of F1+2 decrease correlated with the pretransfusion F1+2 level (R = 0.65, P < 0.0001). The patient series was divided into two groups according to increasing pretransfusional F1+2 level: Group 1 (preFFP F1+2 ≥ 2.35 nm, n = 16), Group 2 (F1+2 <2.35 nm, n = 16). In Group 1, F1+2 decreased on average 1.58 nm (P < 0.01) from the baseline during FFP transfusion but no significant change in the level of F1+2 during the transfusion was observed in Group 2. Pretransfusional levels of individual factors or prothrombin time (PT) did not correlate with the FFP‐associated decrease in F1+2 level. Conclusions: In the patients with the highest pretransfusional thrombin formation, FFP had an acute thrombin‐reducing effect. Pretransfusion thrombin generation markers, rather than PT or individual pro‐ and anticoagulants, may be helpful in identifying the patient who will have measurable coagulational effects induced by FFP.</description><subject>Biomarkers - blood</subject><subject>Blood Coagulation</subject><subject>Female</subject><subject>fresh frozen plasma</subject><subject>Hemorrhage - etiology</subject><subject>Hemorrhage - prevention & control</subject><subject>Humans</subject><subject>Infant, Newborn</subject><subject>Male</subject><subject>newborn</subject><subject>Plasma</subject><subject>Prospective Studies</subject><subject>protein C</subject><subject>thrombin</subject><subject>Thrombin - biosynthesis</subject><subject>Thrombophilia - complications</subject><subject>Thrombophilia - prevention & control</subject><subject>Thrombosis - complications</subject><subject>Thrombosis - prevention & control</subject><issn>1538-7933</issn><issn>1538-7836</issn><issn>1538-7836</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2003</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNqNkM1OwzAQhC0EolB4BZQTtwT_JHYscakqSkGVuJSzZSdrNVUSFztVW56ehBa4ctpZ7ezs6kMoIjghOOUP64RkLI9FznhCMWYJxjRlyf4MXf0Ozn-0ZGyErkNYY0xkRvElGhGaC8JIfoUmMw9hFVnvPqGNNrUOjY48lNsCQtStvGtM1UbW-UZ3lWujvmlhZ5wfpNVtF27QhdV1gNtTHaP32dNyOo8Xb88v08kiLlLCWcwLwJqnQmSCm0ILSqzMqQEtiMlwajljGS8NFSD756TV1nBaSkyM5ASkZWN0f8zdePexhdCppgoF1LVuwW2DEqyP4SntjfnRWHgXggerNr5qtD8ogtWAT63VQEYNlNSAT33jU_t-9e50Y2saKP8WT7x6w-PRsKtqOPw7WL0u571gX3BbfeM</recordid><startdate>200306</startdate><enddate>200306</enddate><creator>Hyytiäinen, S.</creator><creator>Syrjälä, M.</creator><creator>Fellman, V.</creator><creator>Heikinheimo, M.</creator><creator>Petäjä, J.</creator><general>Blackwell Science Inc</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7X8</scope></search><sort><creationdate>200306</creationdate><title>Fresh frozen plasma reduces thrombin formation in newborn infants</title><author>Hyytiäinen, S. ; Syrjälä, M. ; Fellman, V. ; Heikinheimo, M. ; Petäjä, J.</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c4163-6ce0a6477576bca721f982bea71b504f63356db27e92879fafb62d901b961e9f3</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2003</creationdate><topic>Biomarkers - blood</topic><topic>Blood Coagulation</topic><topic>Female</topic><topic>fresh frozen plasma</topic><topic>Hemorrhage - etiology</topic><topic>Hemorrhage - prevention & control</topic><topic>Humans</topic><topic>Infant, Newborn</topic><topic>Male</topic><topic>newborn</topic><topic>Plasma</topic><topic>Prospective Studies</topic><topic>protein C</topic><topic>thrombin</topic><topic>Thrombin - biosynthesis</topic><topic>Thrombophilia - complications</topic><topic>Thrombophilia - prevention & control</topic><topic>Thrombosis - complications</topic><topic>Thrombosis - prevention & control</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Hyytiäinen, S.</creatorcontrib><creatorcontrib>Syrjälä, M.</creatorcontrib><creatorcontrib>Fellman, V.</creatorcontrib><creatorcontrib>Heikinheimo, M.</creatorcontrib><creatorcontrib>Petäjä, J.</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>MEDLINE - Academic</collection><jtitle>Journal of thrombosis and haemostasis</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Hyytiäinen, S.</au><au>Syrjälä, M.</au><au>Fellman, V.</au><au>Heikinheimo, M.</au><au>Petäjä, J.</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Fresh frozen plasma reduces thrombin formation in newborn infants</atitle><jtitle>Journal of thrombosis and haemostasis</jtitle><addtitle>J Thromb Haemost</addtitle><date>2003-06</date><risdate>2003</risdate><volume>1</volume><issue>6</issue><spage>1189</spage><epage>1194</epage><pages>1189-1194</pages><issn>1538-7933</issn><issn>1538-7836</issn><eissn>1538-7836</eissn><abstract>Background: Newborn infants undergoing intensive care are at risk of bleeding and thrombotic complications. Fresh frozen plasma (FFP) is used in hope of preventing these complications, despite poorly defined effects on the coagulation system and lack of proven clinical efficacy. Objectives and methods: We prospectively evaluated coagulopathy and the effect of standardized amount of FFP transfusion (10 mL kg−1 + 4 mL in 2 h) on various coagulation markers in 33 newborn infants during the first 24 h of intensive care. Results: Increased levels of prothrombin fragment F1+2, thrombin–antithrombin complexes (TAT), and d‐dimer were found prior to the transfusion in 97%, 81%, and 100% of the patients, respectively. FFP transfusion was associated with a decrease in F1+2 level in 26/32 (81%) of the patients. The extent of F1+2 decrease correlated with the pretransfusion F1+2 level (R = 0.65, P < 0.0001). The patient series was divided into two groups according to increasing pretransfusional F1+2 level: Group 1 (preFFP F1+2 ≥ 2.35 nm, n = 16), Group 2 (F1+2 <2.35 nm, n = 16). In Group 1, F1+2 decreased on average 1.58 nm (P < 0.01) from the baseline during FFP transfusion but no significant change in the level of F1+2 during the transfusion was observed in Group 2. Pretransfusional levels of individual factors or prothrombin time (PT) did not correlate with the FFP‐associated decrease in F1+2 level. Conclusions: In the patients with the highest pretransfusional thrombin formation, FFP had an acute thrombin‐reducing effect. Pretransfusion thrombin generation markers, rather than PT or individual pro‐ and anticoagulants, may be helpful in identifying the patient who will have measurable coagulational effects induced by FFP.</abstract><cop>Oxford, UK</cop><pub>Blackwell Science Inc</pub><pmid>12871318</pmid><doi>10.1046/j.1538-7836.2003.00243.x</doi><tpages>6</tpages><oa>free_for_read</oa></addata></record> |
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| subjects | Biomarkers - blood Blood Coagulation Female fresh frozen plasma Hemorrhage - etiology Hemorrhage - prevention & control Humans Infant, Newborn Male newborn Plasma Prospective Studies protein C thrombin Thrombin - biosynthesis Thrombophilia - complications Thrombophilia - prevention & control Thrombosis - complications Thrombosis - prevention & control |
| title | Fresh frozen plasma reduces thrombin formation in newborn infants |
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