Platelet transfusion thresholds in neonatal medicine

Moore, Carmel Maria; Curley, Anna

doi:10.1016/j.earlhumdev.2019.104845

Cited by 12 publications

(12 citation statements)

References 24 publications

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“…There are many suggestions that explain the reason behind the harmful effects of the current platelet transfusion practices for neonates. 26 One of those suggestions is that the volume and transfusion speed may lead to harm through hemodynamic effects. 26 Traditionally, platelets are transfused for over 30 to 60 minutes, which leads to sudden a introduction of a large volume of bolus to a sick acidotic neonate with passive cerebral pressure circulation.…”

Section: Discussionmentioning

confidence: 99%

The Association Between Platelet Transfusion and Mortality Rate Among Preterm Neonates in the Eastern Province, Saudi Arabia

Alhamad

Hussein

Alqahtani

2021

Preprint

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Platelet transfusion is the main mode of management of thrombocytopenia. However, some studies link frequent and high-threshold platelet transfusions with an incremental increase of mortality rate. Aim: This study aims to assess the association between the frequency and the threshold of platelet transfusions, with the mortality rate among preterm neonates. Methods: A retrospective cohort study design was used. This study was conducted at maternity and children's hospitals in Al-Ahasa, Saudi Arabia. The sample size includes 154 preterm neonates, included in the study by the use of the convenience sampling technique. Result: There is a significant relationship found between the gestational age and the birth weight of the preterm neonates with the survival rates among both groups. In contrast, there is no significant relationship found between transfusion frequency, transfusion threshold, and the survival rates of the group which received platelet transfusion. Implications for Practice and Research: The current study found that mortality is mainly associated with lower gestational ages, and not platelet transfusions. More studies are needed to fill the remaining gaps of knowledge, and to optimise platelet transfusion practices among preterm neonates. Key Words: platelet transfusion, preterm neonate, platelet transfusion threshold, mortality rate.

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Section: Discussionmentioning

confidence: 99%

The Association Between Platelet Transfusion and Mortality Rate Among Preterm Neonates in the Eastern Province, Saudi Arabia

Alhamad

Hussein

Alqahtani

2021

Preprint

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“…It is therefore uncertain whether a similar decrease also occurred in other NICUs. In the past few decades, the use of RBC and platelets has decreased, after studies showed that restrictive transfusion guidelines were non-inferior to liberal guidelines [19,24,25]. The reduced use of blood products (RBC and platelets) may have contributed to a concomitant decrease in the use of FFP transfusion.…”

Section: Discussionmentioning

confidence: 99%

Changes in the Use of Fresh-Frozen Plasma Transfusions in Preterm Neonates: A Single Center Experience

Houben

Heeger

Stanworth

et al. 2020

JCM

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The aim of this study was to evaluate changes in the use of fresh-frozen plasma (FFP) transfusions and the use of clotting tests in preterm neonates in our center over the past two decades. In this retrospective cohort analysis, we included all consecutive neonates with a gestational age at birth between 24 + 0 and 31 + 6 weeks admitted to our neonatal intensive care unit (NICU) between 2004 and 2019. We divided all included neonates into three consecutive time epochs according to date of birth: January 2004 to April 2009, May 2009 to August 2014 and September 2014 to December 2019. The main outcomes were the use of FFP transfusion, coagulation testing and the indications for FFP transfusion. The percentage of preterm neonates receiving FFP transfusion decreased from 5.7% (47/824) to 3.7% (30/901) to 2.0% (17/852) from the first epoch to the last epoch (p < 0.001). Additionally, the rate of neonates undergoing coagulation testing decreased from 24.3% (200/824) to 14.5% (131/901) to 8% (68/852) over the epochs (p < 0.001). Most FFP transfusions were prescribed prophylactically based on prolongation of activated partial thromboplastin time (aPTT) or prothrombin time (PT) (56%). In conclusion, both the use of FFP transfusions and the use of coagulation tests decreased significantly over the years. The majority of the FFP transfusions were administrated prophylactically for abnormal coagulation tests.

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“…158,159 It is still unknown to what extent such differences may lead to greater microthrombosis or other adverse effects. 155,160,161 The transmission of infectious agents should also be taken into consideration because platelets are the blood component most susceptible to contamination given that concentrates are stored at room temperature. 162 The potential severe adverse effects of transfusions should not be ruled out either (transfusion-related acute lung injury [TRALI], among others), which, given their characteristics, are not easily recognizable in severely-ill newborn infants, so they may be under-recorded.…”

Section: Megaplatelet Inclusion Bodymentioning

confidence: 99%

Neonatal thrombocytopenia: A review. II. Non-immune thrombocytopenia; platelet transfusion

2021

Arch Argent Pediat

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Non-immune thrombocytopenia is caused by multiple pathologies; the most common causes are extra-or intrauterine infections, whereas secondary cases result from other pathologies involved in the fetal-placentalmaternal interface. This second article lists its causes and provides details of the different pathologies. Platelet transfusion is widely used in neonatology, both as treatment and as bleeding prophylaxis. However, there is no general consensus about the platelet count threshold that is convenient to indicate a transfusion or actual indications. Recent articles are commented regarding the different proposed strategies. The emphasis is on discussing the multiple adverse effects of platelet transfusions because knowledge about them is changing the paradigm for indications, suggesting that a much more restrictive policy is required.

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Platelet transfusion thresholds in neonatal medicine

Cited by 12 publications

References 24 publications

The Association Between Platelet Transfusion and Mortality Rate Among Preterm Neonates in the Eastern Province, Saudi Arabia

The Association Between Platelet Transfusion and Mortality Rate Among Preterm Neonates in the Eastern Province, Saudi Arabia

Changes in the Use of Fresh-Frozen Plasma Transfusions in Preterm Neonates: A Single Center Experience

Neonatal thrombocytopenia: A review. II. Non-immune thrombocytopenia; platelet transfusion

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