The Effect of Severe Birth Asphyxia on the Hemostasis System in Newborns During the First Hour of Life

In newborns with severe intranatal asphyxia, the hemostasis system adaptation is impaired, thus increasing the risk of bleeding during the first day of life.The purpose of the work was to evaluate the effect of severe birth asphyxia and metabolic acidosis on the newborns' hemostasis system, bas...

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Main Authors: I. E. Golub, A. A. Zarubin, N. I. Micheeva, A. S. Vanyarkina, O. G. Ivanova
Format: Article
Language:English
Published: Federal Research and Clinical Center of Intensive Care Medicine and Rehabilitology, Moscow, Russia 2017-03-01
Series:Общая реаниматология
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Online Access:https://www.reanimatology.com/rmt/article/view/1570
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author I. E. Golub
A. A. Zarubin
N. I. Micheeva
A. S. Vanyarkina
O. G. Ivanova
author_facet I. E. Golub
A. A. Zarubin
N. I. Micheeva
A. S. Vanyarkina
O. G. Ivanova
author_sort I. E. Golub
collection DOAJ
description In newborns with severe intranatal asphyxia, the hemostasis system adaptation is impaired, thus increasing the risk of bleeding during the first day of life.The purpose of the work was to evaluate the effect of severe birth asphyxia and metabolic acidosis on the newborns' hemostasis system, based on the thromboelastography (TEG) findings.Materials and methods. A retrospective analysis of medical records of 40 severely asphyxiated newborns (group 1) and 20 healthy newborns (group 2) was performed. The study was carried out during the first hour of life of the newborns.Results. Infants in group 1 demonstrated a reduced activity of platelets and enzymatic components of the coagulation. The enzymatic phase of the coagulation hemostasis (P<0.001) and the kinetics of clot strength growth significantly decreased in group 1 newborns, as compared to the second group (P<0.001 and P<0.01, respectively). The fibrin network growth rate and its structurization in group 1 newborns was lower than that in group 2 newborns (P<0.05). The platelet activity in group 1 infants was reduced as compared to group 2 (P< 0.05).Fibrinolysis in newborns did not differ at the 30th minute of the study. The correlation analysis demonstrated that decreased pH and Be values and hyperlactacidemia correlated; platelet and coagulation hemostasis parameters were altered with a shift to hypocoagulation. Conclusion. Thromboelastographic study of whole blood samples demonstrated a shift of the hemostatic system to hypocoagulation for both platelet and enzymatic components of hemostasis, without any changes in the clot lysis in severely asphyxiated newborns.
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spelling doaj-art-0edcfebaa45d4f1bb7d5ab4604b072972025-08-20T02:59:34ZengFederal Research and Clinical Center of Intensive Care Medicine and Rehabilitology, Moscow, RussiaОбщая реаниматология1813-97792411-71102017-03-01131172310.15360/1813-9779-2017-1-17-231540The Effect of Severe Birth Asphyxia on the Hemostasis System in Newborns During the First Hour of LifeI. E. Golub0A. A. Zarubin1N. I. Micheeva2A. S. Vanyarkina3O. G. Ivanova4Irkutsk State Medical University, Russian Ministry of HealthIrkutsk State Medical University, Russian Ministry of Health, Irkutsk City Perinatal CenterIrkutsk City Perinatal CenterIrkutsk City Perinatal CenterIrkutsk City Perinatal CenterIn newborns with severe intranatal asphyxia, the hemostasis system adaptation is impaired, thus increasing the risk of bleeding during the first day of life.The purpose of the work was to evaluate the effect of severe birth asphyxia and metabolic acidosis on the newborns' hemostasis system, based on the thromboelastography (TEG) findings.Materials and methods. A retrospective analysis of medical records of 40 severely asphyxiated newborns (group 1) and 20 healthy newborns (group 2) was performed. The study was carried out during the first hour of life of the newborns.Results. Infants in group 1 demonstrated a reduced activity of platelets and enzymatic components of the coagulation. The enzymatic phase of the coagulation hemostasis (P<0.001) and the kinetics of clot strength growth significantly decreased in group 1 newborns, as compared to the second group (P<0.001 and P<0.01, respectively). The fibrin network growth rate and its structurization in group 1 newborns was lower than that in group 2 newborns (P<0.05). The platelet activity in group 1 infants was reduced as compared to group 2 (P< 0.05).Fibrinolysis in newborns did not differ at the 30th minute of the study. The correlation analysis demonstrated that decreased pH and Be values and hyperlactacidemia correlated; platelet and coagulation hemostasis parameters were altered with a shift to hypocoagulation. Conclusion. Thromboelastographic study of whole blood samples demonstrated a shift of the hemostatic system to hypocoagulation for both platelet and enzymatic components of hemostasis, without any changes in the clot lysis in severely asphyxiated newborns.https://www.reanimatology.com/rmt/article/view/1570hypoxicischemic encephalopathysevere birth asphyxiametabolic acidosisthromboelastographynewbornshemostasis
spellingShingle I. E. Golub
A. A. Zarubin
N. I. Micheeva
A. S. Vanyarkina
O. G. Ivanova
The Effect of Severe Birth Asphyxia on the Hemostasis System in Newborns During the First Hour of Life
Общая реаниматология
hypoxicischemic encephalopathy
severe birth asphyxia
metabolic acidosis
thromboelastography
newborns
hemostasis
title The Effect of Severe Birth Asphyxia on the Hemostasis System in Newborns During the First Hour of Life
title_full The Effect of Severe Birth Asphyxia on the Hemostasis System in Newborns During the First Hour of Life
title_fullStr The Effect of Severe Birth Asphyxia on the Hemostasis System in Newborns During the First Hour of Life
title_full_unstemmed The Effect of Severe Birth Asphyxia on the Hemostasis System in Newborns During the First Hour of Life
title_short The Effect of Severe Birth Asphyxia on the Hemostasis System in Newborns During the First Hour of Life
title_sort effect of severe birth asphyxia on the hemostasis system in newborns during the first hour of life
topic hypoxicischemic encephalopathy
severe birth asphyxia
metabolic acidosis
thromboelastography
newborns
hemostasis
url https://www.reanimatology.com/rmt/article/view/1570
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