Background Derangements of haemostasis are implicated in IVH. Prothrombin time (PT), activated partial thromboplastin time (APTT) and fibrinogen level are frequently monitored in premature infants. Neonates frequently receive frozen plasma (FP) in attempt to correct perceived haemostatic abnormalities based on laboratory results.
Methods Prospective observational study was performed. Blood was drawn into citrated tubes from neonates (<30/40) on admission (n = 76) from non-heparinised lines. Platelet poor plasma was obtained by centrifugation of whole blood; PT, APTT, and fibrinogen were measured and correlated with IVH.
Results Infants with IVH (n = 30) had no significant difference in PT (p = 0.949), APTT (p = 0.405) and fibrinogen (p = 0.560) than those without IVH (n = 46). There was no association between IVH grade and APTT (p = 0.937). There was no significant difference in APTT in those with or without IVH, excluding infants with IVH on admission (p = 0.534). Of patients administered FP, there was no significant difference in IVH (p = 0.38). FP is frequently administered when APTT >100 s. In this subgroup; IVH rates in those that received FP (n = 17) vs. those that did not (n = 4) was not significantly different (p = 0.447). There was no significant difference in IVH development in high risk (APTT >100 s, Administered FP) vs. low risk infants (APTT <100 s, No treatment), (p = 1.00) or when comparing infants with lesser degrees of coagulopathy (APTT 60 s-80 s vs. 80 s-100 s, p = 0.6334).
Conclusions Justification of FP based on coagulation values is unclear. In this study, IVH rates following FP administration was not increased. Coagulation values were not predicative of IVH, indicating lack of therapeutic window for intervention.