Benefits of lower neonatal platelet transfusion thresholds

Hasan, Rida A.; Saifee, Nabiha Huq

doi:10.1111/trf.16386

Cited by 9 publications

(4 citation statements)

References 15 publications

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“…The findings of the PlaNeT-2/MATISSE study are supported by similar findings in smaller randomized trials of platelet count thresholds in neonates 83,98,99 and together inform stronger evidence that liberal transfusion thresholds do not improve clinical outcomes and indeed may be associated with harm.…”

Section: General Considerations For Neonates With Thrombocytopenia Ev...supporting

confidence: 53%

How I diagnose and treat neonatal thrombocytopenia

Stanworth

Mumford

2023

Blood

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Neonatal thrombocytopenia defined as the presence of a circulating platelet count <150x109/L is a common abnormality in babies admitted to Neonatal Intensive Care Units. Thrombocytopenia that is typically mild and self-limiting often accompanies neonatal stress in scenarios such as premature delivery or intrauterine growth restriction. However, the differential diagnosis of neonatal thrombocytopenia is wide and includes potential life-threatening disorders such as bacterial sepsis, viral infection and necrotizing enterocolitis. Distinguishing these causes of thrombocytopenia from entities such as genetic thrombocytopenia and fetal and neonatal alloimmune thrombocytopenia is critical for the accurate quantitation of significant adverse events such as intracranial bleeding and for the selection of treatments such as platelet transfusion. In this review, we focus on common differential diagnoses of neonatal thrombocytopenia and highlight how the landscape of diagnosis and management is changing with recent advances in genomic technology and the completion of pivotal clinical trials of platelet transfusion practice. Increasing evidence highlights the need for judicious and restrictive use of platelet transfusions in neonates.

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Section: General Considerations For Neonates With Thrombocytopenia Ev...supporting

confidence: 53%

How I diagnose and treat neonatal thrombocytopenia

Stanworth

Mumford

2023

Blood

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“…In sum, there is no conclusive evidence of benefit for platelet transfusions in the prevention of major bleeding 18 . Additionally, there are several pathophysiologic mechanisms by which platelet transfusions could harm NICU patients.…”

Section: Platelet Transfusionsmentioning

confidence: 99%

Consensus Blood Product Transfusion Guidelines for a Large Neonatal Care Network

Gilmore,

Chou,

Ghavam

et al. 2023

Preprint

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product transfusions, but clinical practices vary widely. Many very low birth weight (VLBW) infants receive packed red blood cell (RBC) or platelet transfusions during their initial NICU stay, with incidence inversely proportional to gestational age at birth 1,2. Many critically ill infants are also transfused with plasma or cryoprecipitate to promote coagulation 3,4. These blood product transfusions are most often prophylactic, with clinical decisions made in response to numerical blood count values, as opposed to therapeutic transfusions in the context of active bleeding.Emerging evidence has shown that some transfusion practices are harmful for certain NICU patients, such as platelet transfusions in preterm infants 5,6. More broadly, transfusion reactions can occur with virtually all blood products 7 and these reactions are likely under-diagnosed, under-estimated, and under-reported in pediatric patients 3. Our intention was to establish optimal transfusion guidelines for our division and neonatal network, including 19 hospitals, based on a review of currently available literature.

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“…1 In sum, there is no conclusive evidence of benefit for platelet transfusions at currently used thresholds in the prevention of major bleeding. 23 Additionally, there are several pathophysiologic mechanisms by which platelet transfusions could harm NICU patients. Neonatal platelets are distinctly different from adult platelets in terms of reactivity to chemical agonists and in protein content.…”

Section: Platelet Transfusionsmentioning

confidence: 99%

Consensus transfusion guidelines for a large neonatal intensive care network

Gilmore,

Chou,

Ghavam

et al. 2024

Transfusion

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Benefits of lower neonatal platelet transfusion thresholds

Cited by 9 publications

References 15 publications

How I diagnose and treat neonatal thrombocytopenia

How I diagnose and treat neonatal thrombocytopenia

Consensus Blood Product Transfusion Guidelines for a Large Neonatal Care Network

Consensus transfusion guidelines for a large neonatal intensive care network

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