Briefly noted: P Cheung, et al. J Pediatr 2019; 205: 83-90. This study showed that a plasma biomarker for necrotizing enterocolitis (NEC), miR-1290, was very useful in a cohort of 301 neonates.
- Of 20 infants with miR-1290 > 650 copies/microliter, 15 were diagnosed with NEC.
- In those with intermediate values (220-650 copies/microliter) adding CRP (>1.58 mg/dL) allowed for a sensitivity of 0.83, specificity of 0.96, a positive predictive value of 0.75, and a negative predictive value of 0.98.
- The authors state that 7 of 36 infants had NEC diagnosed earlier by 8-32 hrs based on the availability of miR-1290 testing.
My take: Biomarkers are helping us identify serious diseases more quickly and changing how we practice. Hopefully, work in this area will help us identify NEC sooner and improve outcomes.
Below is a visual abstract indicating that transfusion for platelet count less than 25 K was associated with a lower rate of death/major bleeding that a platelet count threshold of 50 K.