Clot strength: a comparison between cord and adult blood by means of thrombelastometry.
OBJECTIVE
To evaluate the clot strength in cord versus adult blood.


METHODS
Thrombelastometry (TEM) was the method of choice as it provides information on the clot strength in terms of the maximum clot firmness (MCF) and on the fibrin polymerization process in terms of the clot formation time and the alpha angle.


RESULTS
The MCFs were significantly lower in cord versus adult platelet rich plasma (PRP, 63.0+/-3.8 vs. 67.0+/-3.9 mm, P=0.006) and in cord versus adult whole blood (WB, 55.3+/-3.8 vs. 59.3+/-3.6 mm, P=0.001) employing the thrombelastometry with extrinsic activator assay. We suggest that the diminished clot strength in cord versus adult blood and plasma samples is attributable to an impaired polymerization of neonatal fibrin: (i) the thrombelastometry with extrinsic activator and inactivated platelets (FIBTEM) assay revealed significantly lower MCFs in cord versus adult PRP (23.0+/-3.1 mm vs. 27.3+/-3.9 mm, P=0.002) and in cord versus adult WB (11.6+/-2.3 mm vs. 15.3+/-3.3 mm, P<0.001); (ii) the alpha angle in the FIBTEM assay was significantly lower in cord versus adult WB (39.0+/-12.8 degrees vs. 55.5+/-12.3 degrees, P=0.02); (iii) the clot formation times in the FIBTEM assay were significantly longer in cord versus adult PRP (248.0+/-143.5 s vs. 81.5+/-39.8 s, P=0.001).


CONCLUSIONS
Neonatal fibrin shows impaired polymerization properties under our experimental conditions resulting in reduced clot strength compared with fibrin of adult origin.
Cvirn
Gerhard
G
Institute of Physiological Chemistry, Department of Pediatrics, Medical University of Graz, Graz, Austria. gerhard.cvirn@meduni-graz.at
Gallistl
Siegfried
S
Kutschera
Joerg
J
Wagner
Thomas
T
Ferstl
Ulrika
U
Jurgens
Gunther
G
Koestenberger
Martin
M
D000328:Adult; D000367:Age Factors; D001777:Blood Coagulation / Q000502:physiology*; D001792:Blood Platelets / Q000502:physiology; D004548:Elasticity; D005312:Fetal Blood / Q000502:physiology*; D006801:Humans; D007231:Infant, Newborn; D012016:Reference Values; D013916:Thrombelastography / Q000379:methods* / Q000592:standards*