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Fibrinolysis in cerebrospinal fluid after intraventricular haemorrhage

A Whitelaw1, L Creighton, P Gaffney

  • 1Department of Paediatrics and Neonatal Medicine, Hammersmith Hospital, London.

Archives of Disease in Childhood
|July 1, 1991
PubMed

Insights

Elevated cross linked fibrin degradation products in cerebrospinal fluid may indicate intraventricular hemorrhage in preterm infants. Higher concentrations are associated with progressive post-hemorrhagic ventricular dilatation.

Area of Science:

  • Neonatal Neurology
  • Biochemistry
  • Pediatric Medicine

Background:

  • Intraventricular hemorrhage (IVH) is a common complication in preterm infants.
  • Fibrin degradation products (FDPs) are markers of coagulation activation and breakdown.
  • Understanding FDP levels in cerebrospinal fluid (CSF) may aid in diagnosing and monitoring IVH.

Purpose of the Study:

  • To measure and compare CSF concentrations of cross linked fibrin degradation products (FDPs) in preterm infants.
  • To investigate the association between FDP levels and the presence and severity of IVH.
  • To evaluate FDPs as potential biomarkers for post-hemorrhagic ventricular dilatation.

Main Methods:

  • Cerebrospinal fluid (CSF) samples were collected from three groups of preterm infants: normal, with IVH, and with progressive post-hemorrhagic ventricular dilatation.
  • Concentrations of cross linked FDPs were quantified using a validated assay.
  • Serial CSF sampling was performed in one infant to track FDP levels over time.

Main Results:

  • Median CSF FDP concentrations were 102 ng/ml in normal preterm infants, 315 ng/ml in those with IVH, and 1000 ng/ml in infants with progressive post-hemorrhagic ventricular dilatation.
  • A significant increase in FDP levels was observed with increasing severity of IVH and ventricular dilatation.
  • Serial sampling revealed a peak FDP concentration two weeks post-hemorrhage in one infant.

Conclusions:

  • CSF cross linked FDP concentrations are significantly elevated in preterm infants with IVH compared to normal controls.
  • Progressive post-hemorrhagic ventricular dilatation is associated with the highest FDP levels, suggesting ongoing or severe fibrinolysis.
  • Cross linked FDPs show potential as sensitive biomarkers for diagnosing and monitoring IVH and its complications in preterm neonates.

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