Document Detail


Prevalance of heparin-dependent platelet-activating antibodies in preterm newborns after exposure to unfractionated heparin.
MedLine Citation:
PMID:  15497019     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
Heparin is frequently used in preterm infants to prolong the patency of intravascular catheters. The aim of this study was to evaluate the prevalence of heparin-dependent platelet-activating antibodies in newborns. A cross-section of all preterm newborn infants expected to require heparin to maintain patency of a central venous access line were enrolled. A blood sample was obtained soon after birth before heparin exposure to exclude the possibility of placental transfer of maternal heparin-dependent platelet-activating antibodies. A second sample was obtained at termination of heparin use (mean duration of heparin exposure was 23 +/- 13 days; range, 6-67). Paired samples, at birth and after heparin use, were available for 42 infants with a mean gestational age of 27.8 +/- 2.2 weeks and birth weight of 1036 +/- 267 g. Thrombocytopenia developed in 57% (24/42) of the infants. None of these infants had clinical suspicion of thrombosis during the study period. The etiology of thrombocytopenia was confirmed sepsis in six, presumed sepsis in three, necrotizing enterocolitis in one, and unclear in 14 infants. Anti-heparin/platelet factor 4 antibodies measured using the standard assays for heparin-induced thrombocytopenia (two commercially available enzyme-linked immunosorbent assay tests and the functional platelet serotonin release assay) were negative on all infants. Although it could be related to the poor ability of these infants to mount an immunologic response, further research is necessary to fully understand this lack of response to heparin and to elucidate further the reasons for thrombocytopenia in very-low-birth-weight infants.
Authors:
Praveen Kumar; Debra A Hoppensteadt; M Margaret Prechel; Ruth B Deddish; Jeanine M Walenga
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  Clinical and applied thrombosis/hemostasis : official journal of the International Academy of Clinical and Applied Thrombosis/Hemostasis     Volume:  10     ISSN:  1076-0296     ISO Abbreviation:  Clin. Appl. Thromb. Hemost.     Publication Date:  2004 Oct 
Date Detail:
Created Date:  2004-10-21     Completed Date:  2005-05-05     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  9508125     Medline TA:  Clin Appl Thromb Hemost     Country:  United States    
Other Details:
Languages:  eng     Pagination:  335-9     Citation Subset:  IM    
Affiliation:
Pediatrics, Northwestern Memorial Hospital, Chicago, Illinois, USA. p-kumar@northwestern.edu
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MeSH Terms
Descriptor/Qualifier:
Autoantibodies / blood*
Blood Platelets / immunology*
Catheterization, Central Venous / adverse effects,  methods
Cross-Sectional Studies
Enzyme-Linked Immunosorbent Assay
Female
Heparin / adverse effects*,  immunology
Humans
Infant, Newborn
Infant, Premature / blood*
Male
Platelet Count
Platelet Factor 4 / immunology
Prevalence
Sepsis / complications
Thrombocytopenia / etiology
Chemical
Reg. No./Substance:
0/Autoantibodies; 37270-94-3/Platelet Factor 4; 9005-49-6/Heparin

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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