Ductus Arteriosus Closure and D-Dimer and Fibrinogen Levels
NCT ID: NCT04508036
Last Updated: 2023-03-01
Study Results
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Basic Information
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UNKNOWN
100 participants
OBSERVATIONAL
2019-03-14
2023-12-31
Brief Summary
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Detailed Description
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When not closed, patent ductus arteriosus (PDA) is formed resulting in shunting from aorta to pulmonary artery. Probability of patency is inversely related with birth weight. Risk of pulmonary edema, pulmonary hemorrhage, bronchopulmonary dysplasia and loss of pulmonary function increases due to increased pulmonary flow from left to right shunt. Renal, mesenteric and cranial blood supply are impaired due to reduced peripheral circulation. As a result, impaired renal function and necrotizing enterocolitis may develop. Risk of intracranial hemorrhage, cerebral hypoxia and premature retinopathy due to variable blood supply. It has been associated with increased mortality in newborns due to increased morbidity. On physical examination, hyperdynamic precordium, viable pulses and left ventricular hypertrophy are observed. Large PDAs are characterized by prominent pulmonary conus, increased pulmonary vascularization and cardiomegaly on telecardiography.
Diagnosis of PDA is confirmed by echocardiography. Symptomatic PDA treatment and follow-up is mostly followed by echocardiography. Detailed echocardiographic examination can only be performed by a Pediatric Cardiologist, but it is not possible to evaluate DA at any time. It is necessary to benefit from significant changes in specific hematological parameters that may accompany DA closure in order to detect and predict these conditions.
One of the main mechanisms involved in anatomic permanent closure in DA is platelet aggregation and coagulation. To the best of our knowledge, there is no study in the literature investigating whether there is a relationship between Fibrinogen and D-dimer levels and anatomical closure of DA. It is postulated that circulating fibrinogen levels will decrease and D-dimer levels increase as a by-product due to thrombosis in the lumen during DA closure. It is predicted that in infants in whom DA does not close and remain open, fibrinogen levels will be higher and D-dimer levels will be lower than infants in whom DA is closed. It is also suggested that echocardiographic DA measurements will correlate with serum Fibrinogen and D-Dimer levels.
The aim of this study is to investigate whether there is a relationship between echocardiographic measurements regarding closure of PDA and serum D-Dimer and Fibrinogen levels in premature infants born before 32nd gestational week and weighing less than 1500 grams.
Conditions
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Study Design
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COHORT
PROSPECTIVE
Study Groups
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Study Group
Premature newborns born before 32nd gestational week and weighing less than 1500 grams.
Withdrawal of blood samples for D-Dimer
Blood samples are withdrawn at birth via cord blood and at postnatal 3rd and 7th days via umbilical catheter in order to test for D-dimer levels.
Withdrawal of blood samples for Fibrinogen
Blood samples are withdrawn at birth via cord blood and at postnatal 3rd and 7th days via umbilical catheter in order to test for Fibrinogen levels.
Echocardiographic Examination
At postnatal 3rd, 7th and 14th days, Ductus Arteriosus will be echocardiographically examined to obtain calculations and confirm status of ductal patency or closure.
Interventions
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Withdrawal of blood samples for D-Dimer
Blood samples are withdrawn at birth via cord blood and at postnatal 3rd and 7th days via umbilical catheter in order to test for D-dimer levels.
Withdrawal of blood samples for Fibrinogen
Blood samples are withdrawn at birth via cord blood and at postnatal 3rd and 7th days via umbilical catheter in order to test for Fibrinogen levels.
Echocardiographic Examination
At postnatal 3rd, 7th and 14th days, Ductus Arteriosus will be echocardiographically examined to obtain calculations and confirm status of ductal patency or closure.
Eligibility Criteria
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Inclusion Criteria
Exclusion Criteria
* Major congenital anomalies
* Chromosomal anomalies
* Inborn errors of metabolism
* Hypoxic ischemic encephalopathy
* Disseminated intravascular coagulation
* Unstable hemodynamic status
* Severe neonatal sepsis
* Who died in time frame of postnatal 14 days
* Patients who are not volunteered to participate
0 Days
28 Days
ALL
Yes
Sponsors
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Hacettepe University
OTHER
Responsible Party
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H. Tolga Çelik
Associate Professor of Neonatology
Principal Investigators
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Hasan Tolga Çelik
Role: STUDY_CHAIR
Hacettepe University
Alper Aykanat
Role: PRINCIPAL_INVESTIGATOR
Hacettepe University
İlker Ertuğrul
Role: PRINCIPAL_INVESTIGATOR
Hacettepe University
Locations
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Hacettepe University
Ankara, , Turkey (Türkiye)
Countries
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Central Contacts
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Facility Contacts
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References
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Tay SP, Cheong SK, Boo NY. Circulating tissue factor, tissue factor pathway inhibitor and D-dimer in umbilical cord blood of normal term neonates and adult plasma. Blood Coagul Fibrinolysis. 2003 Feb;14(2):125-9. doi: 10.1097/00001721-200302000-00002.
Sehgal A, Paul E, Menahem S. Functional echocardiography in staging for ductal disease severity : role in predicting outcomes. Eur J Pediatr. 2013 Feb;172(2):179-84. doi: 10.1007/s00431-012-1851-0. Epub 2012 Oct 11.
Other Identifiers
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KA-19033
Identifier Type: -
Identifier Source: org_study_id
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