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<b><i>Background:</i></b> Prophylactic platelet transfusion has been adopted as a ubiquitous practice in management of thrombocytopenia in preterm infants to reduce the risk of bleeding. <b><i>Objectives:</i></b> The objectives of this study were to report the prevalence of platelet transfusion among preterm infants with thrombocytopenia and to assess the association of platelet transfusion with mortality and morbidity in this population. <b><i>Methods:</i></b> A cross-sectional study that utilized National Inpatient Sample for the years 2000–2017 was conducted. All preterm infants delivered nationally with birth weight (BW) &#x3c;1,500 g or gestational age &#x3c;32 weeks were included. Analyses were repeated after stratifying the population into 2 BW subcategories &#x3c;1,000 g and 1,000–1,499 g. Logistic regression analysis was performed to adjust for confounding variables. <b><i>Results:</i></b> The study included 1,780,299 infants; of them, 22,609 (1.27%) were diagnosed with thrombocytopenia and 5,134 (22.7%) received platelet transfusion. Platelet transfusion was associated with significant increase in mortality (24.8 vs. 13.8%), retinopathy of prematurity (22.3 vs. 19.2%), severe intraventricular hemorrhage (18.3 vs. 10.1%), median length of hospital stays (51 vs. 47 days), and cost of hospitalization (USD 298,204 vs. USD 219,760). Increased mortality was noted in &#x3c;1,000-g infants (aOR = 1.96, CI: 1.76–2.18, <i>p</i> &#x3c; 0.001) and 1,000–1,499-g infants (aOR = 2.02, CI: 1.62–2.53, <i>p</i> &#x3c; 0.001). Platelet transfusion increased over the years in infants with BW &#x3c;1,000 g (<i>p</i> = 0.001) and in infants with BW 1,000–1,499 g (<i>p</i> &#x3c; 0.001). <b><i>Conclusions:</i></b> Platelet transfusion is associated with increased mortality and comorbidities in premature infants. There is a trend for increased utilization of platelet transfusions over the study period.

Objective: Identify the rates and trends of various procedures performed on newborns. Study Design: The HCUP database for the years 2002 to 2015 was queried for the number of livebirths, and various procedures using ICD-9 codes. These were adjusted to the rate of livebirths in each particular year. A hypothetical high-volume hospital based on data from the last 5 years was used to estimate the frequency of each procedure. Results: Over the study period, there was a decline in the rates of exchange transfusions and placement of arterial catheters. There was an increase in the rates of thoracentesis, abdominal paracentesis, placement of UVC lines, and central lines with ultrasound or fluoroscopic guidance. No change was observed in the rates of unguided central lines, pericardiocentesis, bladder aspiration, intubations, and LP. Intubations were the most performed procedures. Placement of UVC, central venous lines (including PICCs), arterial catheters, and LP were relatively common, whereas others were rare such as pericardiocentesis and paracentesis. Conclusions: Some potentially lifesaving procedures are extremely rare or decreasing in incidence. There has also been an increase in utilization of fluoroscopic / ultrasound guidance for the placement of central venous catheters.

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Multisystem inflammatory syndrome (MIS) is a rare entity that usually presents with a constellation of symptoms such as fever, hypotension, gastrointestinal symptoms, cardiac dysfunction, or dermatological involvement, representing an inflammatory state. During the ongoing severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) pandemic, several cases of multisystem inflammatory syndrome in children (MIS-C) have been described in the literature. The Centers for Disease Control and Prevention (CDC) has acknowledged the increasing incidence of the same entity in adults, referred to as multisystem inflammatory syndrome in adults (MIS-A). This case series describes four patients who presented to the Monmouth Medical Center in New Jersey with symptoms suggestive of MIS-A associated with SARS-CoV-2 infection and their clinical outcomes. All patients were within the age group of 20-40 years with no underlying medical condition. The period between SARS-CoV-2 infection and the development of MIS-A varied from 10 days through a month. Presentations ranged from a mild flu-like illness to shock requiring vasopressors. A positive SARS-CoV-2 antibody test was essential for the diagnosis. Inflammatory markers, such as ferritin, D-dimer, C-reactive protein (CRP), erythrocyte sedimentation rate (ESR), and interleukin-6 (IL-6), were elevated on admission. The Use of immunomodulatory agents, namely steroids and intravenous immunoglobulin (IVIG), resulted in positive clinical outcomes. Inflammatory markers and imaging on admission did not appear to predict the disease course. A positive SARS-CoV-2 polymerase chain reaction (PCR) did not appear to influence the response to treatment. Given the high probability of MIS-A with negative viral testing, the use of both antibody and viral testing with the addition of inflammatory markers may be essential to diagnose this SARS-CoV-2-associated condition.