Antithrombotic Properties of Heparin in a Neonatal Piglet Model of Thrombin-Induced Thrombosis

Summary

The relative deficiency of antithrombin III (AT III) in neonatal plasma results in lower recovery of heparin in some assay systems. It is uncertain whether low AT III levels also limit the antithrombotic effects of heparin in this age group. We therefore compared the antithrombotic properties of heparin in mature pigs and newborn piglets, whose coagulation and inhibitor system closely resembles that of the human neonate. Animals were pretreated with saline, 10 or 25 U/kg heparin (n ≥16 per age group and dose). Following an injection of 100 U/kg thrombin, systemic ¹²⁵I-fibrinogen consumption and local ¹²⁵I-fibrinogen incorporation into jugular venous stasis thrombi were measured. Significantly more ¹²⁵I-fibrinogen was consumed in piglets than in pigs systemically (p <0.0001), as well as within the occluded vein segment (p = 0.0112), largely because heparin was less effective in piglets than in pigs. This neonatal resistance to heparin could not be explained by lower heparin levels in the newborn animals. However, pretreatment with AT III concentrate significantly improved the antithrombotic properties of heparin in this age group (p <0.0001). We conclude that physiologically low AT III levels reduce the efficacy of heparin in neutralizing thrombin activity in newborn piglets. We speculate that AT III deficiency may also limit the antithrombotic properties of heparin in newborn infants with thrombotic disease.

Keywords

Heparin - Newborn infant - Piglets - Antithrombotic properties

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