Forum for Science, Industry and Business

Sponsored by:     3M 
Search our Site:

 

Study sheds new light on post-operative bleeding in newborns

07.03.2016

A new study finds significant differences between the blood clot structure in adults and newborns, helping researchers better understand the challenges in addressing post-operative bleeding in neonatal patients. The researchers also found that the current standard of care for treating post-operative bleeding may pose an increased risk of thrombosis in newborns compared to adults, which researchers hadn't suspected. The study was performed by researchers at North Carolina State University, the University of North Carolina at Chapel Hill, Emory University, Children's Healthcare of Atlanta and the Georgia Institute of Technology.


These are laser scanning confocal microscopy images of clots constructed from adult fibrinogen (A), neonatal fibrinogen (B), or a mixture of the two (C). Scale bar= 20 μm.

Credit: Ashley Brown

"We knew that neonates - infants less than one month old - are more likely than adults to suffer from severe bleeding after heart surgery, which poses a variety of health risks," says Ashley Brown, first author of a paper on the study and an assistant professor in the joint biomedical engineering department at NC State and UNC-Chapel Hill.

"The current standard of care is to give neonatal patients blood products - such as a protein called fibrinogen - derived from adult blood," Brown says. "But neonatal blood and adult blood aren't the same; many of the components involved in clotting in newborns have differing levels of activity, or effectiveness, compared to the same components in adults. Our goal was to better understand how clotting in neonates differs from that in adults, so that we can move closer to developing more effective treatment strategies for these infants."

The researchers' hypothesis was that fibrinogen - the main blood-clotting protein - from neonates would form clots that are different from those formed by adult fibrinogen, and they were correct. However, they were surprised to find that fibrinogen from adults did not integrate well with the fibrinogen in neonates. In other words, the fibrinogen from adults and newborns wouldn't stick to each other and form a clot.

To test this hypothesis, the researchers took samples of neonate fibrinogen and adult fibrinogen and compared how they formed clots. They looked at clots formed solely of adult fibrinogen, clots formed solely of neonate fibrinogen, and clots formed of mixed adult and neonate fibrinogen.

The researchers found that neonate fibrinogen formed less dense, more fragile clots than adult fibrinogen. And they found that a mixture of adult and neonate fibrinogen formed clots that were also fragile and less dense - even if there was relatively little neonate fibrinogen in the mixture.

The researchers also evaluated how long it took these clots to dissolve. This is important because blood clots that don't break down can form thrombosis or be released into the bloodstream and cause a stroke.

The study showed that clots of neonate fibrinogen dissolve about twice as quickly as clots formed from adult fibrinogen. It also showed that clots formed from an adult and neonate fibrinogen mixture dissolved at approximately the same rate as adult-only clots - regardless of the percentage of neonate fibrinogen in the mixture.

"This suggests that using adult fibrinogen in neonatal patients may pose an increased risk of embolism or other adverse thrombotic events," says Nina Guzzetta, MD, corresponding author on the study, associate professor of anesthesiology at Emory University School of Medicine, and a pediatric cardiac anesthesiologist at Children's Healthcare of Atlanta.

"This work drives home that newborns are not just small adults, and we still have much to learn about clotting in neonates," Guzzetta says. "It also tells us that there is a great deal of room for improvement in the current standard of care for post-operative bleeding in neonates.

"We are investigating several approaches that may help address this problem, evaluating various modes of action," Brown says. "It is possible that we can use various external factors that promote clotting to stimulate the fibrinogen in neonates to form a denser clot. We are investigating possible alternatives to help neonates form a better clot after major surgery without having to use adult fibrinogen. For example, we are investigating the use of synthetic platelet-like particles developed by our team to augment hemostasis - the biological process that stops bleeding - in blood samples collected from these patients."

###

The paper, "Fibrin network changes in neonates after cardiopulmonary bypass," was published online March 3 in the journal Anesthesiology. The paper was co-authored by Riley Hannan, now at the University of Virginia; Lucas Timmins and Thomas Barker of the biomedical engineering program at Georgia Tech and Emory; and Janet Fernandez of Children's Healthcare of Atlanta. The work was supported by the Emory University and Children's Healthcare of Atlanta Children's Center for Cardiovascular Biology and by the National Institutes of Health under grant R21EB019068.

Media Contact

Matt Shipman
matt_shipman@ncsu.edu
919-515-6386

 @NCStateNews

http://www.ncsu.edu 

Matt Shipman | EurekAlert!

Further reports about: Healthcare biomedical engineering bleeding clots neonatal

More articles from Health and Medicine:

nachricht NIST scientists discover how to switch liver cancer cell growth from 2-D to 3-D structures
17.11.2017 | National Institute of Standards and Technology (NIST)

nachricht High speed video recording precisely measures blood cell velocity
15.11.2017 | ITMO University

All articles from Health and Medicine >>>

The most recent press releases about innovation >>>

Die letzten 5 Focus-News des innovations-reports im Überblick:

Im Focus: A “cosmic snake” reveals the structure of remote galaxies

The formation of stars in distant galaxies is still largely unexplored. For the first time, astron-omers at the University of Geneva have now been able to closely observe a star system six billion light-years away. In doing so, they are confirming earlier simulations made by the University of Zurich. One special effect is made possible by the multiple reflections of images that run through the cosmos like a snake.

Today, astronomers have a pretty accurate idea of how stars were formed in the recent cosmic past. But do these laws also apply to older galaxies? For around a...

Im Focus: Visual intelligence is not the same as IQ

Just because someone is smart and well-motivated doesn't mean he or she can learn the visual skills needed to excel at tasks like matching fingerprints, interpreting medical X-rays, keeping track of aircraft on radar displays or forensic face matching.

That is the implication of a new study which shows for the first time that there is a broad range of differences in people's visual ability and that these...

Im Focus: Novel Nano-CT device creates high-resolution 3D-X-rays of tiny velvet worm legs

Computer Tomography (CT) is a standard procedure in hospitals, but so far, the technology has not been suitable for imaging extremely small objects. In PNAS, a team from the Technical University of Munich (TUM) describes a Nano-CT device that creates three-dimensional x-ray images at resolutions up to 100 nanometers. The first test application: Together with colleagues from the University of Kassel and Helmholtz-Zentrum Geesthacht the researchers analyzed the locomotory system of a velvet worm.

During a CT analysis, the object under investigation is x-rayed and a detector measures the respective amount of radiation absorbed from various angles....

Im Focus: Researchers Develop Data Bus for Quantum Computer

The quantum world is fragile; error correction codes are needed to protect the information stored in a quantum object from the deteriorating effects of noise. Quantum physicists in Innsbruck have developed a protocol to pass quantum information between differently encoded building blocks of a future quantum computer, such as processors and memories. Scientists may use this protocol in the future to build a data bus for quantum computers. The researchers have published their work in the journal Nature Communications.

Future quantum computers will be able to solve problems where conventional computers fail today. We are still far away from any large-scale implementation,...

Im Focus: Wrinkles give heat a jolt in pillared graphene

Rice University researchers test 3-D carbon nanostructures' thermal transport abilities

Pillared graphene would transfer heat better if the theoretical material had a few asymmetric junctions that caused wrinkles, according to Rice University...

All Focus news of the innovation-report >>>

Anzeige

Anzeige

Event News

Ecology Across Borders: International conference brings together 1,500 ecologists

15.11.2017 | Event News

Road into laboratory: Users discuss biaxial fatigue-testing for car and truck wheel

15.11.2017 | Event News

#Berlin5GWeek: The right network for Industry 4.0

30.10.2017 | Event News

 
Latest News

NASA detects solar flare pulses at Sun and Earth

17.11.2017 | Physics and Astronomy

NIST scientists discover how to switch liver cancer cell growth from 2-D to 3-D structures

17.11.2017 | Health and Medicine

The importance of biodiversity in forests could increase due to climate change

17.11.2017 | Studies and Analyses

VideoLinks
B2B-VideoLinks
More VideoLinks >>>