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Acta medica Croatica : Časopis Akademije medicinskih znanosti Hrvatske, Vol. 73 No. 2, 2019.

Review article

PARTICULARITIES OF COAGULATION IN CHILDREN

ERNEST BILIĆ ; University of Zagreb, School of Medicine, Department of Pediatrics, Department of Hematology and Oncology, Zagreb University Hospital Centre, Zagreb, Croatia
GABRIJELA IVANKOVIĆ ; University of Zagreb, School of Medicine, Zagreb, Croatia

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Abstract

Haemorrhagic and thrombotic events occur in both children and adults. The underlying causes are congenital or acquired disorders. The maturation and postnatal development of the human coagulation system results in significant and important differences in the coagulation and fibrinolysis of neonates and young children compared to older children and adults. Platelet function, pro- and anticoagulant protein concentrations and fibrinolytic pathway protein concentrations are developmentally regulated and generate hemostatic homeostasis that is unique to the neonatal period. At the same time, neonates have a predisposition to bleeding and develepment of thrombosis. These differences, which mostly reflect the immaturity of the neonatal haemostasis system, are functionally balanced. Central lines, fluid fluctuations, sepsis, liver dysfunction and inflammation contribute to the risk profile for thrombosis development in ill neonates. Hemophilia is the
most common of the severe bleeding disorders and should be considered in the neonatal period in case of unusual bleeding or positive family history. Later, hemophilia should be suspected mainly in males because of abnormal bleeding following invasive procedures. Prophylactic treatment that is started early with clotting-factor concentrates has been shown to prevent hemophilic arthropathy and is therefore the gold standard of care for hemophilia A and B. Children with coagulation disorders should be clinically and laboratory treated according to the exact type and degree of clotting disorder and appropriate treatment should be conducted. This significantly reduces the possibility of acute complications and long-term consequences.

Keywords

coagulation; children

Hrčak ID:

224707

URI

https://hrcak.srce.hr/224707

Publication date:

6.9.2019.

Article data in other languages: croatian

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