Platelet dysfunction in the neonate with essential fatty acid deficiency

Area of Science:

• Biochemistry
• Neonatal Medicine
• Hematology

Background:

• Parenteral nutrition (PN) in premature infants can lead to essential fatty acid (EFA) deficiency.
• EFA deficiency impacts various physiological processes, including hemostasis.

Purpose of the Study:

• To investigate the effect of EFA deficiency on platelet aggregation in sick premature newborns.
• To explore the relationship between EFA deficiency, platelet dysfunction, and clinical hemorrhage.

Main Methods:

• Assessed platelet aggregation in response to adenosine diphosphate (ADP) in five EFA-deficient premature infants on fat-free PN.
• Diagnosed EFA deficiency via plasma lipid fatty acid analysis.
• Compared platelet function to control low-birth-weight infants fed orally.

Main Results:

• EFA-deficient infants exhibited significantly impaired platelet aggregation (e.g., 18.1% vs. 43.4% at 2.5 muM ADP).
• Platelets from deficient infants showed marked disaggregation.
• Four of five EFA-deficient infants experienced clinical hemorrhage.
• Platelet function normalized upon recovery from EFA deficiency.

Conclusions:

• EFA deficiency, specifically of arachidonic acid, is strongly correlated with impaired platelet aggregation mediated by thromboxane A2.
• The findings support a hypothesis that EFA deficiency causally contributes to platelet dysfunction and bleeding in premature infants.
• This highlights the importance of adequate EFA provision in neonatal PN.