Format

Send to:

Choose Destination
See comment in PubMed Commons below
Vox Sang. 2013 Apr;104(3):207-13. doi: 10.1111/j.1423-0410.2012.01658.x. Epub 2012 Oct 9.

Restrictive guideline reduces platelet count thresholds for transfusions in very low birth weight preterm infants.

Author information

  • 1Neonatal Division of Medicine, Department of Pediatrics, Federal University of São Paulo, SP, Brazil.

Abstract

BACKGROUND AND OBJECTIVES:

Platelet transfusions are performed almost entirely according to expert experience. This study assessed the effectiveness of a restrictive guideline to reduce platelet transfusions in preterm infants.

METHODS:

A retrospective cohort of preterm infants with a birth weight of <1500 g had been born in 2 periods. In Period 1, a transfusion was indicated for a platelet count of <50,000/ml in clinically stable neonates or <100,000/ml in bleeding or clinically unstable infants. In Period 2, the indications were restricted to <25,000/ml in clinically stable neonates, or <50,000/ml in newborns who were either on mechanical ventilation, subject to imminent invasive procedures, within 72 h following a seizure, or extremely premature and <7 days old. A count of <100,000/ml was indicated for bleeding or major surgery.

RESULTS:

Periods 1 and 2 comprised 121 and 134 neonates, respectively. The rates of ventricular haemorrhage and intrahospital death were similar in both periods. The percentage of transfused infants, the odds of receiving a platelet transfusion, the mean platelet count before transfusion and the percentage of transfusions with a platelet count >50,000/ml were greater in Period 1. Among thrombocytopenic neonates, the percentage of transfused neonates and the number of transfusions were similar in both groups.

CONCLUSION:

The restrictive guideline for platelet transfusions reduced the platelet count thresholds for neonatal transfusions without increasing the rate of ventricular haemorrhage.

© 2012 The Author(s). Vox Sanguinis © 2012 International Society of Blood Transfusion.

KEYWORDS:

guideline; infant; neonatal intensive care unit; platelet transfusion; thrombocytopenia; very low birth weight

PMID:
23046429
[PubMed - indexed for MEDLINE]
PubMed Commons home

PubMed Commons

0 comments
How to join PubMed Commons

    Supplemental Content

    Full text links

    Icon for Wiley
    Loading ...
    Write to the Help Desk