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 Satellites, airport visibility readings shed light on troops' exposure to air pollution
09.12.2016 | Veterans Affairs Research Communications

nachricht Oxygen can wake up dormant bacteria for antibiotic attacks
08.12.2016 | Penn State

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: Electron highway inside crystal

Physicists of the University of Würzburg have made an astonishing discovery in a specific type of topological insulators. The effect is due to the structure of the materials used. The researchers have now published their work in the journal Science.

Topological insulators are currently the hot topic in physics according to the newspaper Neue Zürcher Zeitung. Only a few weeks ago, their importance was...

Im Focus: Significantly more productivity in USP lasers

In recent years, lasers with ultrashort pulses (USP) down to the femtosecond range have become established on an industrial scale. They could advance some applications with the much-lauded “cold ablation” – if that meant they would then achieve more throughput. A new generation of process engineering that will address this issue in particular will be discussed at the “4th UKP Workshop – Ultrafast Laser Technology” in April 2017.

Even back in the 1990s, scientists were comparing materials processing with nanosecond, picosecond and femtosesecond pulses. The result was surprising:...

Im Focus: Shape matters when light meets atom

Mapping the interaction of a single atom with a single photon may inform design of quantum devices

Have you ever wondered how you see the world? Vision is about photons of light, which are packets of energy, interacting with the atoms or molecules in what...

Im Focus: Novel silicon etching technique crafts 3-D gradient refractive index micro-optics

A multi-institutional research collaboration has created a novel approach for fabricating three-dimensional micro-optics through the shape-defined formation of porous silicon (PSi), with broad impacts in integrated optoelectronics, imaging, and photovoltaics.

Working with colleagues at Stanford and The Dow Chemical Company, researchers at the University of Illinois at Urbana-Champaign fabricated 3-D birefringent...

Im Focus: Quantum Particles Form Droplets

In experiments with magnetic atoms conducted at extremely low temperatures, scientists have demonstrated a unique phase of matter: The atoms form a new type of quantum liquid or quantum droplet state. These so called quantum droplets may preserve their form in absence of external confinement because of quantum effects. The joint team of experimental physicists from Innsbruck and theoretical physicists from Hannover report on their findings in the journal Physical Review X.

“Our Quantum droplets are in the gas phase but they still drop like a rock,” explains experimental physicist Francesca Ferlaino when talking about the...

All Focus news of the innovation-report >>>

Anzeige

Anzeige

Event News

ICTM Conference 2017: Production technology for turbomachine manufacturing of the future

16.11.2016 | Event News

Innovation Day Laser Technology – Laser Additive Manufacturing

01.11.2016 | Event News

#IC2S2: When Social Science meets Computer Science - GESIS will host the IC2S2 conference 2017

14.10.2016 | Event News

 
Latest News

Researchers identify potentially druggable mutant p53 proteins that promote cancer growth

09.12.2016 | Life Sciences

Scientists produce a new roadmap for guiding development & conservation in the Amazon

09.12.2016 | Ecology, The Environment and Conservation

Satellites, airport visibility readings shed light on troops' exposure to air pollution

09.12.2016 | Health and Medicine

VideoLinks
B2B-VideoLinks
More VideoLinks >>>