Could Platelet Mass Index Be Used As A Marker In Preterm Infants With Patent Ductus Arteriosus?

Yıl 2017, Cilt: 14 Sayı: 1, 25 - 27, 01.01.2017

Nilüfer Okur Mehmet Büyüktiryaki Nurdan Uraş Gülsüm Kadıoğlu Şimşek Fuat Emre Canpolat Şerife Suna Oğuz

Öz

Objective: Patent Ductus Arteriozus is one of the most important problems of premature infants in neonatal intensive care units. The aim of this study is to investigate the role of platelet mass index in predisposed infants with hsPDA foreseeing PDA closure.Materials and methods: We retrospectively evaluated the data of preterm infants who had hemodynamic PDA after 32 h and 32 weeks and 1250 g postnatal hours. Platelet counts, MPV and platelet mass index values were evaluated before and after treatment in patients with and without PDA treatment.Findings: A total of 161 patients who received inpatient treatment and diagnosed with hsPDA in the NICU between March 2014 and March 2016 were included in the study. Mean gestational age of the patients was 27 ± 2 weeks, mean birth weight was 948 ± 223 grams. One hundred thirteen 84% patients received PDA after treatment. Twenty-two 16% patients had hemodynamic significant PDA openness. Platelet count, MPV and platelet mass index were not significantly different between groups.Conclusion: In this study, we did not find any significant association between PDA closure and platelet count, MPV and platelet mass in patients with hsPDA who received ibuprofen and paracetamol therapy.

Anahtar Kelimeler

PDA, Premature, Platelet mass index

Patent Duktus Arteriosuslu Preterm Yenidoğanlarda Platelet Mass İndex Bir Belirteç Olarak Kullanılabilir Mi?

Öz

Amaç: Patent Duktus Arteriozus, yenidoğan yoğun bakım ünitelerinde prematüre infantların en önemli problemlerden biridir. Bu çalışmanın amacı hsPDA’sı olan pretem bebeklerde platelet mass indeksinin PDA’nın kapanmasını öngörmedeki rolünü araştırmaktır.Gereç ve Yöntemler: Postnatal 72. saatinden sonra hemodinamik anlamlı PDA saptanan, 32 hafta ve 1250 g altı preterm infantların verileri retrospektif olarak değerlendirildi. PDA tedavisi ile kapanma olan ve olmayan hasta gruplarında, tedavi öncesi ve sonrası platelet sayısı, MPV ve platelet mass indeks değerleri değerlendirildi.Bulgular: Çalışmaya Mart 2014-Mart 2016 tarihleri arasında YYBÜ’nde yatarak tedavi gören ve hsPDA tanısı konulan 161 hasta alındı. Hastaların ortalama gestasyon yaşı 27±2 hafta, ortalama doğum ağırlığı 948±223 gramdı. Yüz on üç %84 hastada tedavi sonrası PDA kapandı. Yirmi iki %16 hastanın hemodinamik anlamlı PDA açıklığı devam etmekteydi. Gruplar arasında platelet sayısı, MPV ve platelet mass indeks açısından anlamlı fark saptanmadı.Sonuç: Bu çalışmada ibuprofen ve parasetamol tedavisi verilen hsPDA’sı olan hastalarda PDA kapanması ile platelet sayısı, MPV ve platelet mass arasında anlamlı bir ilişki saptamadık.

Anahtar Kelimeler

PDA, premature, platelet mass

Kaynakça

• Bancalari E, Claure N, Gonzalez A. Patent ductus arteriosus and respiratory outcome in premature infants. Biol Neonate 2005;88: 192- 201.
• Stoll BJ, Hansen NI, Bell EF, Shankaran S, Laptook AR, Walsh MC, et al. Neonatal outcomes of extremely preterm infants from the NICHD neonatalresearch network. Pediatrics 2010;126:443-56.
• Coceani F and Baragatti B. Mechanisms for ductus arteriosus closure. Semin Perinatol 2012; 36:92-97.
• Boo NY, Mohd-Amin I, Bilkis AA, Yong-Junina F. Predictors of failed closure of patent ductus arteriosus with indomethacin. Singapore Med J 2006;47:763–8.
• Shah NA, Hills NK, Waleh N, et al. Relationship between circulating platelet counts and ductus arteriosus patency after indomethacin treatment. J Pediatr 2011;158:919–23.
• Zisk, Jody L., et al. “Transfusing neonates based on platelet count vs. platelet mass: a randomized feasibility-pilot study.” Platelets 25.7 (2014): 513-516.
• Mehta P, Vasa R, Neumann L, Karpatkin M. Thrombocytopenia in the high-risk infant. J Pediatr 1980; 97:791–794.
• Zisk JL, Mackley A, Christensen RD, Paul DA. Is a small platelet mass associated with intraventricular hemorrhage in very lowbirth- weight infants? J Perinatol 2011;31:776–779.
• Echtler K, Stark K, Lorenz M, et al. Platelets contribute to postnatal occlusion of the ductus arteriosus. Nat Med 2010;16:75–82.
• Karpatkin S. Heterogeneity of human platelets. II. Functional evidence suggestive of young and old platelets. J Clin Invest 1969; 48:1083–7.
• Kamath S, Blann AD, Lip GY. Platelet activation: assessment and quantification. Eur Heart J 2001; 22:1561–71.
• Bath PM, Butterworth RJ. Platelet size: measurement, physiology and vascular disease. Blood Coagul Fibrinolysis 1996;7:157–61.
• Canpolat FE, Yurdakok M, Armangil D, Yigit S. Mean platelet volume in neonatal respiratory distress syndrome. Pediatr Int 2009;51:314–6.
• Okur Nilufer, et al. “Platelet mass index in very preterm infants: can it be used as a parameter for neonatal morbidities?.” J Matern Fetal Neonatal Med 2016; 29; 3218-22.
• Akar Selahattin, et al. “Does platelet mass influence the effectiveness of ibuprofen treatment for patent ductus arteriosus in preterm infants?.” J Matern Fetal Neonatal Med 2016; 29; 3218-22.