Additional Treatment with Low-Molecular-Weight Heparin Provides a Better Patient Outcome for Neonatal Pulmonary Hemorrhage with Unfractionated Heparin Treatment

Abstract

Pulmonary hemorrhage occurring in preterm newborns is a catastrophic event and is significantly associated with neonatal deaths. Low-weight-molecular heparin is a medical agent usually used as anticoagulants during pregnancy and has the advantages of good absorption, long half-life, and high bioavailability. This study evaluated the pulmonary function and coagulation function in neonates with pulmonary hemorrhage following intravenous drip of low-molecular-weight heparin and the effects of low-molecular-weight heparin on serum prealbumin and retinol-binding protein levels. A total of 96 neonates with pulmonary hemorrhage were included as study subjects and arranged into the control group and the observation group, 48 per group, based on intravenous drip of unfractionated heparin with or without low-molecular-weight heparin. The neonates receiving intravenous drip of unfractionated heparin and low-molecular-weight heparin exhibited elevated partial pressure of oxygen (PaO2) concomitant with declined partial pressure of carbon (PaCO2) compared to those receiving unfractionated heparin treatment alone. With regard to pulmonary function, neonates receiving combined treatment of unfractionated heparin and low-molecular-weight heparin displayed increased forced expiratory volume in the first second (FEV1), FEV1/forced expiratory vital capacity (FVC), and peak expiratory flow (PEF) ( $P<0.05$ ) when comparable to neonates receiving unfractionated heparin treatment alone. As for coagulation function, neonates with pulmonary hemorrhage had decreased activated partial thromboplastin time (APTT), prothrombin time (PT), thromboplastin time (TT), and fibrinogen (FIB) after treatment. Expectedly, these decreases were more significantly in neonates undergoing unfractionated heparin coupled with low-molecular-weight heparin ( $P<0.05$ ). The control group was given unfractionated heparin, and the observation group was given unfractionated heparin coupled with low-molecular-weight heparin. In addition to pulmonary function and coagulation function, it was also observed that neonates undergoing unfractionated heparin coupled with low-molecular-weight heparin exhibited higher serum levels of serum prealbumin and retinol-binding protein than those treated with unfractionated heparin alone. Finally, higher recovery rate and lower incidence rate of complications, such as pulmonary infection, intracranial hemorrhage, and respiratory distress, were found in the observation group than the control group ( $P<0.05$ ). In conclusion, additional treatment with low-molecular-weight heparin could provide a better patient outcome for neonatal pulmonary hemorrhage with unfractionated heparin treatment, as it could notably improve pulmonary function and coagulation function and reduce the incidence of complications.