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Thrombin Generation in Preterm Newborns With Intestinal Failure-Associated Liver Disease

Background and Aim: Intestinal failure-associated liver disease (IFALD) affects one-fifth of neonates receiving parenteral nutrition (PN) for more than 2 weeks. We aimed to define the effect of IFALD on hemostasis of preterm infants. Methods: This is an ancillary analysis of a prospective study aime...

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Autores principales: Ghirardello, Stefano, Raffaeli, Genny, Scalambrino, Erica, Cortesi, Valeria, Roggero, Paola, Peyvandi, Flora, Mosca, Fabio, Tripodi, Armando
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Frontiers Media S.A. 2020
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7479833/
https://www.ncbi.nlm.nih.gov/pubmed/32984220
http://dx.doi.org/10.3389/fped.2020.00510
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author Ghirardello, Stefano
Raffaeli, Genny
Scalambrino, Erica
Cortesi, Valeria
Roggero, Paola
Peyvandi, Flora
Mosca, Fabio
Tripodi, Armando
author_facet Ghirardello, Stefano
Raffaeli, Genny
Scalambrino, Erica
Cortesi, Valeria
Roggero, Paola
Peyvandi, Flora
Mosca, Fabio
Tripodi, Armando
author_sort Ghirardello, Stefano
collection PubMed
description Background and Aim: Intestinal failure-associated liver disease (IFALD) affects one-fifth of neonates receiving parenteral nutrition (PN) for more than 2 weeks. We aimed to define the effect of IFALD on hemostasis of preterm infants. Methods: This is an ancillary analysis of a prospective study aimed at defining coagulation in preterm infants. We included neonates exposed to PN (at least 14 days), in full-enteral feeding. We compared thrombin generation in the presence of thrombomodulin, defined as endogenous thrombin potential-ETP, PT, aPTT between infants with IFALD vs. those without (controls), at birth, and after 30 days. IFALD was defined as conjugated bilirubin ≥1 mg/dl. Results: We enrolled 92 preterm infants (32 IFALD; 60 controls). Cholestatic patients had a lower birthweight, longer exposure to PN, and longer hospitalization. Infants with IFALD showed longer median PT (12.8-vs.-12 sec; p = 0.02) and aPTT (39.2-vs.-36.5 sec; p = 0.04) than controls, with no difference in ETP. Conclusions: Despite prolonged PTs and aPTTs infants with IFALD had similar ETP than those without.
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spelling pubmed-74798332020-09-26 Thrombin Generation in Preterm Newborns With Intestinal Failure-Associated Liver Disease Ghirardello, Stefano Raffaeli, Genny Scalambrino, Erica Cortesi, Valeria Roggero, Paola Peyvandi, Flora Mosca, Fabio Tripodi, Armando Front Pediatr Pediatrics Background and Aim: Intestinal failure-associated liver disease (IFALD) affects one-fifth of neonates receiving parenteral nutrition (PN) for more than 2 weeks. We aimed to define the effect of IFALD on hemostasis of preterm infants. Methods: This is an ancillary analysis of a prospective study aimed at defining coagulation in preterm infants. We included neonates exposed to PN (at least 14 days), in full-enteral feeding. We compared thrombin generation in the presence of thrombomodulin, defined as endogenous thrombin potential-ETP, PT, aPTT between infants with IFALD vs. those without (controls), at birth, and after 30 days. IFALD was defined as conjugated bilirubin ≥1 mg/dl. Results: We enrolled 92 preterm infants (32 IFALD; 60 controls). Cholestatic patients had a lower birthweight, longer exposure to PN, and longer hospitalization. Infants with IFALD showed longer median PT (12.8-vs.-12 sec; p = 0.02) and aPTT (39.2-vs.-36.5 sec; p = 0.04) than controls, with no difference in ETP. Conclusions: Despite prolonged PTs and aPTTs infants with IFALD had similar ETP than those without. Frontiers Media S.A. 2020-08-26 /pmc/articles/PMC7479833/ /pubmed/32984220 http://dx.doi.org/10.3389/fped.2020.00510 Text en Copyright © 2020 Ghirardello, Raffaeli, Scalambrino, Cortesi, Roggero, Peyvandi, Mosca and Tripodi. http://creativecommons.org/licenses/by/4.0/ This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) and the copyright owner(s) are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
spellingShingle Pediatrics
Ghirardello, Stefano
Raffaeli, Genny
Scalambrino, Erica
Cortesi, Valeria
Roggero, Paola
Peyvandi, Flora
Mosca, Fabio
Tripodi, Armando
Thrombin Generation in Preterm Newborns With Intestinal Failure-Associated Liver Disease
title Thrombin Generation in Preterm Newborns With Intestinal Failure-Associated Liver Disease
title_full Thrombin Generation in Preterm Newborns With Intestinal Failure-Associated Liver Disease
title_fullStr Thrombin Generation in Preterm Newborns With Intestinal Failure-Associated Liver Disease
title_full_unstemmed Thrombin Generation in Preterm Newborns With Intestinal Failure-Associated Liver Disease
title_short Thrombin Generation in Preterm Newborns With Intestinal Failure-Associated Liver Disease
title_sort thrombin generation in preterm newborns with intestinal failure-associated liver disease
topic Pediatrics
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7479833/
https://www.ncbi.nlm.nih.gov/pubmed/32984220
http://dx.doi.org/10.3389/fped.2020.00510
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