PB0596 - Hypocoagulation and platelet dysfunction in very and extremely premature newborns with sepsis

Monday, June 24, 2024

13:45 – 14:45 ICT

Room: Exhibition Hall

Co-Author(s)

AI

Anastasia Ignatova

Research associate
Dmitry Rogachev National Medical Research Centеr of Pediatric Hematology, Oncology and Immunology
Moscow, Moskva, Russia

Co-Author(s)

SC

Svetlana V. Cherkasova

Head of the department, MD
N.F. Filatov Children's City Hospital
Moscow, Moskva, Russia
AB

Anna D. Beltsova

Student
I.M. Sechenov First Moscow State Medical University (Sechenov University)
Moscow, Moskva, Russia
EK

Ekaterina M. Koltsova

Leading researcher, PhD
Dmitry Rogachev National Medical Research Center Of Pediatric Hematology, Oncology and Immunology
Moskva, Moskva, Russia
AK

Anna D. Kuprash

Research associate
Dmitry Rogachev National Research Center of Pediatric Hematology, Oncology and Immunology
Moscow, Moskva, Russia

Presenting Author(s)

Elena A. Seregina, PhD

Leading Researcher
Dmitry Rogachev National Medical Research Centеr of Pediatric Hematology, Oncology and Immunology
Moscow, Moskva, Russia

Co-Author(s)

EP

Evgeniya A. Ponomarenko

Junior researcher, PhD
Dmitry Rogachev National Research Center of Pediatric Hematology, Oncology and Immunology
Moscow, Moskva, Russia
GS

Galina S. Svidelskaya

Junior researcher
Center for Theoretical Problems of Physicochemical Pharmacology RAS
Moscow, Moskva, Russia
AB

Anna N. Balandina

Senior researcher, PhD
Dmitry Rogachev National Research Center of Pediatric Hematology, Oncology and Immunology
Moscow, Moskva, Russia
GN

Galina A. Novichkova

General director, MD
Dmitry Rogachev National Research Center of Pediatric Hematology, Oncology and Immunology
Moscow, Moskva, Russia
MP

Mikhail Panteleev

Director
Center for Theoretical Problems of Physico-Сhemical Pharmacology
Moscow, Moskva, Russia

Background: Neonatal sepsis is frequently accompanied by coagulopathy and thrombocytopenia, but the impact of sepsis on platelet function and coagulation in preterm neonates are not well understood.

Aims: We compared coagulation and platelet functional activity in very and extremely premature newborns with sepsis and those who have undergone sepsis.

Methods: Eleven preterm neonates (gestational age 24-33weeks) with sepsis from intensive care unit (group1.1, n=4, age 8-10days and group1.2, n=7, age 29(16-52)days) and 16 preterm neonates (gestational age 26-30weeks) who recovered from sepsis (group2 – age 70(18-179)days) was enrolled. Most of the patients (80%) had hemorrhagic complications, some patients received heparin. Coagulation was assessed using an integral assay of thrombodynamics and standard coagulation assays, platelet functional activity was estimated by flow cytometry, soluble thrombomodulin concentration (Cth) was determined by ELISA. The Mann–Whitney U test were used.

Results: Thrombodynamics of neonates with sepsis was age-dependent: clot growth rates (mkm/min) was increased in group1.1 (46.8(18.6–76.5)) and was decreased in group1.2 (15.8(6.9–29.0)) compared to group2 (29.1(3.8–40.8)) (p < 0.05). Five out of 11 patients with sepsis had spontaneous clotting. Platelets of patients with sepsis was significantly larger (forward scattering, glycoprotein Ib) and hyporeactive (glycoprotein IIbIIIa, annexin V, dense granule release) compared to group2. The concentration of soluble thrombomodulin (ng/ml) was significantly higher in older newborns with sepsis — Cthgroup1.1=3.6(2.9–14.1), Cthgroup1.2=20.3(3.7–69.5) vs Cthgroup2=5.7(0.5–16.8).

Conclusion(s): Hemostasis of very and extremely premature newborns with sepsis is characterized by pronounced plasma hypocoagulation, reduced functional activity of platelets and a general activation of the endothelium in comparison with premature newborns who had sepsis before and have undergone it.

The study was performed in accordance with the Declaration of Helsinki and was approved by the institutional ethics committee. All parents gave informed consent.

The study was supported by the endowment foundation “Science for Children”.

A.Ignatova, S.Cherkasova & A.Beltsova - contributed equally