The use of blood products in perinatal medicine

Lindern, Jeannette S von; Brand, Anneke

doi:10.1016/j.siny.2008.03.001

Cited by 15 publications

(13 citation statements)

References 68 publications

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“…Guidelines suggest administering platelet transfusion if the platelet count is 50-100 × 10 9 /L in a newborn with clinical bleeding or within 24 hours before surgery; if the platelet count is 30-50 × 10 9 /L in a clinically unstable newborn or birth weight <1500 g; if the platelet count falls below 30 × 10 9 /L in a stable patient [10,[17][18][19]. However, the guidelines were expert opinions and were not evidence-based; since the decision to transfuse is dependent on the clinician responsible for the infant's medical management at night and weekend shifts, in the present study our unit could not strictly adhere to the guidelines.…”

Section: Platelet Transfusion Guidelinesmentioning

confidence: 99%

The Prevalence and Outcomes of Thrombocytopenia in a Neonatal Intensive Care Unit: A Three-Year Report

Bolat

Kılıç

Oflaz

et al. 2012

Pediatric Hematology and Oncology

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Neonatal thrombocytopenia is one of the most common hematologic disorders in neonatal intensive care units (NICUs). The purpose of this study was to determine the prevalence of thrombocytopenia and whether thrombocytopenia has an effect on the occurrence of intraventricular hemorrhage (IVH) ≥ grade 2 and on mortality rate. This study was carried out retrospectively in neonates admitted to NICU of Cumhuriyet University in Sivas, Turkey, between 2009 and 2012. Among 2218 neonates evaluated, 208 (9.4%) developed thrombocytopenia. The prevalence of IVH ≥ grade 2 was more in infants with thrombocytopenia (7.2%) than in those without thrombocytopenia (4.4%), although this was not statistically significant (P = .08). In univariate analysis, IVH ≥ grade 2 was higher in cases with very severe thrombocytopenia (35.7%, n = 5) than in those with mild (2.1%, n = 2), moderate (4.7%, n = 3), and severe thrombocytopenia (15.2%, n = 5) (P = .04). Multivariate logistic regression analysis showed that birth weight <1500 g (OR 6.2, 95% CI 3.4-9.8; P = .0001), gram-negative sepsis (OR 2.5, 95% CI 1.8-4.2; P = .01), very severe thrombocytopenia (OR 1.3, 95% CI 1.1-2.1; P = .03), and platelet transfusion ≥2 (OR 7.3, 95% CI 4.1-12.1; P = .001) were significant risk factors for mortality. The results of our study suggest that outcomes of neonates with thrombocytopenia depend not only on platelet count but also on decreased gestational age or birth weight, prenatal factors, and sepsis.

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Section: Platelet Transfusion Guidelinesmentioning

confidence: 99%

The Prevalence and Outcomes of Thrombocytopenia in a Neonatal Intensive Care Unit: A Three-Year Report

Bolat

Kılıç

Oflaz

et al. 2012

Pediatric Hematology and Oncology

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“…Autologous blood transfusions have been shown to be safe in both adult and pediatric patients (17,21,25). Umbilical/placental cord blood is autologous blood from a neonate (20), and the use of autologous umbilical cord blood (UCB) has long been discussed among neonatologists (5,6,9,10,29). Owing to the increasing utilization of UCB for the transplantation of hematopoietic stem cells, significant progress has been made in developing safer and more efficient collection techniques for UCB (12,14).…”

mentioning

confidence: 99%

Comparison of the Bactec 9240 and BacT/Alert Blood Culture Systems for Evaluation of Placental Cord Blood for Transfusion in Neonates

et al. 2009

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The Bactec 9240 and the BacT/Alert blood culture systems were compared as a means for detection of bacterial contaminants in whole blood, concentrated red cells, and plasma preparations prepared from umbilical cord blood (UCB) samples. Ninety-two UCB units seeded with low levels of various bacteria were evaluated. In more than 50% of cases, growth was not detected in plasma using either system (P < 0.001). When concentrated red cells and whole blood were compared, the Bactec system detected bacterial growth consistently sooner than the BacT/Alert system in all seeded bacteria except Staphylococcus species in whole blood. The median lengths of time to detection (LTD) for whole blood and concentrated cells in BacT/Alert were 18.7 h and 18.5 h, respectively. The median LTD for the same blood fractions using the Bactec system were 16.05 h and 15.64 h. These differences in LTD by blood culture system and sample type were statistically significant (whole blood, P ‫؍‬ 0.0449; concentrated cells, P ‫؍‬ 0.0037). Based on the results of our study, we recommend the use of either concentrated red cells or whole blood for sterility testing in UCB samples. In our laboratory, the Bactec system compared to the BacT/Alert system was the superior method for rapid detection of bacterial contaminants in cord blood.While all neonates experience a decline in their circulating red blood cells immediately after birth, anemia is a more common complication for premature neonates (27,28). Annually in the United States, an estimated 130,000 anemic, critically ill infants receive approximately one million red blood cell transfusions (31). Autologous blood transfusions have been shown to be safe in both adult and pediatric patients (17,21,25). Umbilical/placental cord blood is autologous blood from a neonate (20), and the use of autologous umbilical cord blood (UCB) has long been discussed among neonatologists (5,6,9,10,29). Owing to the increasing utilization of UCB for the transplantation of hematopoietic stem cells, significant progress has been made in developing safer and more efficient collection techniques for UCB (12,14). In neonates, bacterial contamination has been described as the third most common cause of transfusion-related fatality, with most fatalities occurring in gram-negative sepsis (13). Unfortunately, many cases of transfusion-transmitted bacterial infection remain unrecognized and underreported (4, 18, 30). While much experience exists now regarding the efficacy, recovery, and safety of UCB, only few studies investigated the prevalence of bacterial contamination of cord blood. These studies report variable bacterial contamination rates of between 1.85 and 12% (3,7,8,10,14). Bacterial contamination consists predominantly of organisms known as typical skin contaminants similar to those described in adult blood culture collections. Organisms of the vaginal flora have been described as an additional and important component of contaminants in UCB. The American Association of Blood Banks (AABB) standards require that a small ...

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“…The decision to use IUT to treat fetal anemia must be balanced against the risks inherent in the procedure [4].…”

Section: Discussionmentioning

confidence: 99%

“…Moreover, IUTs often produce a transient decrease in cardiac output, and iron overload is a long-term effect of both hemolysis and transfusion [4]. This is why a noninvasive diagnostic protocol for fetal anemia should be highly accurate, joining high sensitivity and good specificity, and causing no harm to the fetus.…”

Section: Discussionmentioning

confidence: 99%

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Combined use of the cardiofemoral index and middle cerebral artery Doppler velocimetry for the prediction of fetal anemia

Cabral

Reis

Apocalypse

et al. 2010

Intl J Gynecology & Obste

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The use of blood products in perinatal medicine

Cited by 15 publications

References 68 publications

The Prevalence and Outcomes of Thrombocytopenia in a Neonatal Intensive Care Unit: A Three-Year Report

The Prevalence and Outcomes of Thrombocytopenia in a Neonatal Intensive Care Unit: A Three-Year Report

Comparison of the Bactec 9240 and BacT/Alert Blood Culture Systems for Evaluation of Placental Cord Blood for Transfusion in Neonates

Combined use of the cardiofemoral index and middle cerebral artery Doppler velocimetry for the prediction of fetal anemia

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