Document Detail

Massively elevated nucleated red blood cells and cerebral or pulmonary hemorrhage in severely growth-restricted infants--is there more than coincidence?
MedLine Citation:
PMID:  18784431     Owner:  NLM     Status:  MEDLINE    
BACKGROUND: An elevated nucleated red blood cell (NRBC) count is an independent risk factor for postnatal bleeding complications in growth-restricted infants. The etiology of this phenomenon is unclear. OBJECTIVES: To demonstrate a correlation between massively elevated NRBC counts, coagulopathies and unusual or severe bleeding complications. METHODS: The medical records of all severely growth-restricted very low birth weight (VLBW) infants (gestational age <32 0/7 weeks and birth weight at or below the third percentile) admitted to the Neonatal and Pediatric Intensive Care Unit of the Children's Hospital of Lucerne over a 6-year period were reviewed. NRBC counts and coagulation profiles of infants with unusual and/or severe bleeding complications were compared with those of infants without such complications. RESULTS: From a total of 20 severely growth-restricted VLBW infants, 6 had severe or atypical bleeding complications. Among the infants with hemorrhagic complications, the NRBC counts were significantly higher than in the group without such complications (median 24.2 vs. 4.5 x 10(9)/l, p = 0.028). In 2 infants with severe bleeding complications, in whom coagulation studies were performed prior to the occurrence of the hemorrhagic complications, severe clotting abnormalities in addition to massively elevated NRBC counts were detected. CONCLUSIONS: In infants with massively elevated NRBC counts, coagulation studies should be performed. Early and aggressive support of the coagulation system may help to prevent severe bleeding complications in such patients.
M A Steurer; T M Berger
Publication Detail:
Type:  Case Reports; Journal Article     Date:  2008-09-11
Journal Detail:
Title:  Neonatology     Volume:  94     ISSN:  1661-7819     ISO Abbreviation:  -     Publication Date:  2008  
Date Detail:
Created Date:  2008-11-10     Completed Date:  2009-01-27     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  101286577     Medline TA:  Neonatology     Country:  Switzerland    
Other Details:
Languages:  eng     Pagination:  314-9     Citation Subset:  IM    
Copyright Information:
Copyright 2008 S. Karger AG, Basel.
Department of Pediatrics, Neonatal and Pediatric Intensive Care Unit, Children's Hospital of Lucerne, Lucerne, Switzerland.
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MeSH Terms
Blood Coagulation Disorders / blood*,  pathology
Cerebral Hemorrhage / blood*,  pathology
Erythroblasts / pathology*
Erythrocyte Count
Fatal Outcome
Fetal Growth Retardation / blood*,  pathology
Fibrinogen / metabolism
Infant, Newborn
Infant, Very Low Birth Weight
Partial Thromboplastin Time
Prothrombin Time
Retrospective Studies
Reg. No./Substance:

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