AUTHOR=Ghirardello Stefano , Raffaeli Genny , Scalambrino Erica , Cortesi Valeria , Roggero Paola , Peyvandi Flora , Mosca Fabio , Tripodi Armando 

TITLE=Thrombin Generation in Preterm Newborns With Intestinal Failure-Associated Liver Disease

JOURNAL=Frontiers in Pediatrics

VOLUME=8

YEAR=2020

URL=https://www.frontiersin.org/journals/pediatrics/articles/10.3389/fped.2020.00510

DOI=10.3389/fped.2020.00510

ISSN=2296-2360

ABSTRACT=<p><bold>Background and Aim:</bold> Intestinal failure-associated liver disease (IFALD) affects one-fifth of neonates receiving parenteral nutrition (PN) for more than 2 weeks. We aimed to define the effect of IFALD on hemostasis of preterm infants.</p><p><bold>Methods:</bold> This is an ancillary analysis of a prospective study aimed at defining coagulation in preterm infants. We included neonates exposed to PN (at least 14 days), in full-enteral feeding. We compared thrombin generation in the presence of thrombomodulin, defined as endogenous thrombin potential-ETP, PT, aPTT between infants with IFALD vs. those without (controls), at birth, and after 30 days. IFALD was defined as conjugated bilirubin ≥1 mg/dl.</p><p><bold>Results:</bold> We enrolled 92 preterm infants (32 IFALD; 60 controls). Cholestatic patients had a lower birthweight, longer exposure to PN, and longer hospitalization. Infants with IFALD showed longer median PT (12.8-vs.-12 sec; <italic>p</italic> = 0.02) and aPTT (39.2-vs.-36.5 sec; <italic>p</italic> = 0.04) than controls, with no difference in ETP.</p><p><bold>Conclusions:</bold> Despite prolonged PTs and aPTTs infants with IFALD had similar ETP than those without.</p>