{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,3]],"date-time":"2026-09-03T02:33:02Z","timestamp":1788402782524,"version":"build-2803163510"},"reference-count":30,"publisher":"Wiley","issue":"10","license":[{"start":{"date-parts":[[2024,7,18]],"date-time":"2024-07-18T00:00:00Z","timestamp":1721260800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100003196","name":"Ministero della Salute","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100003196","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Pediatric Blood &amp; Cancer"],"published-print":{"date-parts":[[2024,10]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Background<\/jats:title><jats:p>In the literature, there are no studies about the transfusion threshold for neonates with hypoxic\u2010ischemic encephalopathy (HIE) undergoing therapeutic hypothermia (TH). In order to facilitate accurate interpretation of coagulation results in these neonates, we aimed to generate specific reference intervals in this specific population.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>This retrospective study included all HIE neonates admitted from 2014 to 2022 to undergo TH. All infants during TH underwent blood exams, including the coagulation profile. Our primary outcome was to assess the estimates of the 3rd, 10th, 25th, 50th, 75th, 90th, and 97th percentiles for each parameter on admission (before transfusion). By the receiver operating characteristic (ROC) analysis, the area under the ROC curve (AUC) and the best cut\u2010off point were used to evaluate the ability of the prothrombin time expressed as international normalized ratio (PT\u2010INR) to predict the risk of any bleeding.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>A total of 143 infants were included in this study. On admission, the median fibrinogen value was 205\u00a0mg\/dL, prothrombin time 18.6\u00a0seconds, PT\u2010INR 1.50, activated partial thromboplastin time 38.3\u00a0seconds, thrombin time 18.6\u00a0seconds, antithrombin 57.0%. The optimal cut\u2010off of PT\u2010INR in predicting the risk of any bleeding was greater than 1.84 (AUC\u00a0.623, <jats:italic>p<\/jats:italic>\u00a0=\u00a0.024).<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>For the first time, we proposed the percentiles of coagulation parameters in our cohort of neonates with HIE. Furthermore, we found that a PT\u2010INR greater than 1.84 can significantly predict the risk of any bleeding. Further studies are needed to determine if a restrictive versus a liberal transfusion approach can be equally safer for these high\u2010risk infants.<\/jats:p><\/jats:sec>","DOI":"10.1002\/pbc.31193","type":"journal-article","created":{"date-parts":[[2024,7,18]],"date-time":"2024-07-18T10:01:28Z","timestamp":1721296888000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":3,"title":["Coagulation profiles and percentiles in neonates with hypoxic\u2010ischemic encephalopathy undergoing therapeutic hypothermia: A step toward more accurate transfusion thresholds"],"prefix":"10.1002","volume":"71","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-9076-9838","authenticated-orcid":false,"given":"Domenico Umberto","family":"De Rose","sequence":"first","affiliation":[{"name":"Neonatal Intensive Care Unit \u201cBambino Ges\u00f9\u201d Children's Hospital IRCCS  Rome 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