Coagulopathy screening and early plasma treatment for the prevention of intraventricular hemorrhage in preterm infants.
BACKGROUND
Despite the improvement in the assistance and treatment of preterm infants, intraventricular hemorrhage (IVH) remains a frequent complication in these patients. Our aim was to demonstrate the hypothesis that a coagulopathy screening and the early treatment with fresh-frozen plasma (FFP) of proven coagulopathy may contribute to decrease the occurrence of IVH in infants with gestational age of less than 29 weeks.


METHODS
This study compared two cohorts of infants who received FFP (10 mL/kg) after the evidence of pathologic coagulation tests performed within 2 hours after birth (screening group, n = 127) or after the development of bleedings and evidence of pathologic coagulation tests (no-screening group, n = 91).


RESULTS
The screening strategy decreased the relative risk (RR) of developing IVH (RR = 0.65; 95% confidence interval, 0.44-0.98) compared to no-screening strategy, but the effect was limited to infants born at 23 to 26 weeks of gestation in whom screening strategy lowered IVH occurrence (34.5% vs. 61.1%, p = 0.008).


CONCLUSIONS
A coagulopathy screening strategy decreases the risk of developing IVH in preterm infants but this effect is limited to infants born at 23 to 26 weeks of gestation.
Dani
Carlo
C
Department of Surgical and Medical Critical Care, Section of Neonatology, Careggi University Hospital of Florence, Florence, Italy. cdani@unifi.it
Poggi
Chiara
C
Ceciarini
Federica
F
Bertini
Giovanna
G
Pratesi
Simone
S
Rubaltelli
Firmino F
FF
D001778:Blood Coagulation Disorders / Q000175:diagnosis* / Q000453:epidemiology / Q000628:therapy*; D002543:Cerebral Hemorrhage / Q000453:epidemiology / Q000517:prevention & control*; D002552:Cerebral Ventricles; D015331:Cohort Studies; D017707:Erythrocyte Transfusion / Q000706:statistics & numerical data; D005260:Female; D005865:Gestational Age; D006801:Humans; D015994:Incidence; D007231:Infant, Newborn; D007234:Infant, Premature / Q000097:blood*; D008297:Male; D015997:Neonatal Screening; D010949:Plasma; D017713:Platelet Transfusion / Q000706:statistics & numerical data; D011446:Prospective Studies; D012307:Risk Factors