| Principles of hemostasis in children: models and maturation. | |
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MedLine Citation:
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PMID: 20849450 Owner: NLM Status: In-Process |
Abstract/OtherAbstract:
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Hemostasis is an active process regulating the formation and dissolution of fibrin clot to preserve vascular integrity. The different phases of hemostasis are coordinated so that effective clotting occurs only at the site of vascular injury while maintaining blood flow in other parts of the circulation. Procoagulant processes culminate in thrombin generation and fibrin clot formation to protect the vasculature against uncontrolled bleeding after injury. Conversely, anticoagulant processes limit clot extension to unaffected portions of the vasculature. Lastly, fibrinolysis is responsible for clot dissolution once tissue repair and regeneration permit the return of normal blood flow. A precise and delicate interplay exists among these processes to ensure normal hemostasis. The hemostatic system is incompletely developed at birth and matures throughout infancy. Both full-term and preterm neonates are born with low levels of most procoagulant proteins including all the contact activation factors and vitamin K-dependent factors. Similarly, levels of the major anticoagulant proteins are low at birth. Although often characterized as 'immature', the neonatal hemostatic system is nevertheless functionally balanced with no tendency toward coagulopathy or thrombosis. In this article, we will review the current models of hemostasis and the maturation of the hemostatic system. Our goal is to help clinicians gain a better understanding of the actions of procoagulant agents and of the disruptive effects of serious systemic illnesses on the precarious hemostatic balance of infants. |
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Authors:
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Nina A Guzzetta; Bruce E Miller |
Publication Detail:
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Type: Journal Article Date: 2010-09-16 |
Journal Detail:
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Title: Paediatric anaesthesia Volume: 21 ISSN: 1460-9592 ISO Abbreviation: Paediatr Anaesth Publication Date: 2011 Jan |
Date Detail:
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Created Date: 2010-12-15 Completed Date: - Revised Date: - |
Medline Journal Info:
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Nlm Unique ID: 9206575 Medline TA: Paediatr Anaesth Country: France |
Other Details:
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Languages: eng Pagination: 3-9 Citation Subset: IM |
Copyright Information:
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© 2010 Blackwell Publishing Ltd. |
Affiliation:
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Department of Anesthesiology, Emory University School of Medicine, Children's Healthcare of Atlanta, Atlanta, Georgia 30322, USA. nina.guzzetta@emoryhealthcare.org |
Export Citation:
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From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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