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Neonatal thrombocytopenia: what we do and don't know
Martha Sola-Visner1, Matthew A Saxonhouse, Rachel E Brown
1Drexel University College of Medicine, and St. Christopher's Hospital for Children, Drexel University Neonatology Research at MCP, Philadelphia, PA 19129, United States. Marth.Sola-Visner@drexelmed.edu
Early Human Development
|August 8, 2008
Summary
Neonatal thrombocytopenia affects many infants in the NICU. Current evidence suggests platelet transfusions may not benefit non-bleeding infants with counts over 50 x 10(9)/L, but more research is needed.
Area of Science:
- Neonatology
- Hematology
Background:
- Neonatal thrombocytopenia affects 22-35% of NICU infants.
- Causes are classified as early (<72h) or late (>72h) onset.
- Most cases are mild, but 25% have counts <50 x 10(9)/L, requiring consideration for platelet transfusions.
Purpose of the Study:
- To review current evidence on platelet transfusion triggers in neonatal thrombocytopenia.
- To assess the efficacy of transfusion thresholds in preventing intraventricular hemorrhage (IVH).
Main Methods:
- Literature review of studies on neonatal thrombocytopenia and platelet transfusions.
- Analysis of existing evidence regarding transfusion triggers and outcomes like IVH.
Main Results:
- Limited evidence exists for established platelet transfusion guidelines in neonates.
- Transfusing platelets to non-bleeding neonates with counts >50 x 10(9)/L did not reduce IVH risk.
- A threshold of 30 x 10(9)/L may be adequate for stable, non-bleeding neonates.
Conclusions:
- Current evidence on neonatal platelet transfusion triggers is limited.
- Further multi-center studies are required to establish definitive transfusion guidelines and confirm safety.
- A threshold of 30 x 10(9)/L shows potential for stable, non-bleeding neonates.
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