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Preoperative coagulation tests in former preterm infants undergoing spinal anaesthesia
L De Saint Blanquat1, L Simon, C Laplace
1Départment d'Anesthésie-Réanimation, Hôpital Saint Vincent de Paul, Assistance Publique-Hôpitaux de Paris, Paris, France.
Paediatric Anaesthesia
|May 2, 2002
Summary
Preoperative coagulation tests are recommended for infants undergoing spinal anesthesia. Activated partial thromboplastin time (aPTT) was frequently abnormal in preterm infants younger than 45 weeks, but no complications occurred.
Area of Science:
- Pediatric Anesthesiology
- Pediatric Hematology
- Neonatology
Background:
- Clinical history alone is inadequate for detecting hemostasis disorders in infants under 1 year.
- Laboratory coagulation testing is advised for infants prior to perimedullar anesthesia.
Purpose of the Study:
- To evaluate preoperative coagulation tests in former preterm infants undergoing spinal anesthesia.
- To assess the utility of activated partial thromboplastin time (aPTT), prothrombin time, and platelet count.
Main Methods:
- Retrospective study of 141 former preterm infants.
- Analysis of preoperative coagulation tests (aPTT, prothrombin time, platelet count).
- Infants had recovered from significant medical events before surgery.
Main Results:
- Abnormal activated partial thromboplastin time (aPTT) values were observed in 60.4% of infants with a postconceptional age under 45 weeks.
- No complications related to spinal puncture or abnormal bleeding were reported.
- Standard coagulation tests may not fully reflect coagulation status in this population.
Conclusions:
- Further evaluation of alternative coagulation tests is needed for infants under 45 weeks postconceptional age.
- Current tests may not accurately predict bleeding risk in this specific infant group.
- The findings suggest a need for refined coagulation assessment strategies in neonates and young infants.
