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Routine Screening Method for Microparticles in Platelet Transfusions

Routine Screening Method for Microparticles in Platelet Transfusions

Published on: January 31, 2018

Transfusing neonates based on platelet count vs. platelet mass: a randomized feasibility-pilot study.

Jody L Zisk¹, Amy Mackley, Gerrard Clearly

¹Department of Neonatology, Einstein Medical Center Montgomery , East Norriton, PA , USA .

|November 15, 2013

Summary

This pilot study found that using platelet mass, not just count, to guide neonatal intensive care unit (NICU) platelet transfusions is feasible. However, a large sample size is needed for future trials to confirm if this method reduces transfusion rates.

Keywords:

Neonatal intensive care unit neonatal platelet transfusions platelet mass platelet transfusion thrombocytopenia

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Area of Science:

Neonatal Medicine
Hematology
Clinical Trials

Background:

Platelet transfusions are common in neonatal intensive care units (NICUs).
Current transfusion triggers are often based on platelet count, but platelet mass may be more accurate.
Determining the optimal transfusion strategy requires further investigation.

Purpose of the Study:

To assess the feasibility of a pilot trial comparing platelet mass versus platelet count as transfusion triggers in neonates.
To gather data for estimating the sample size required for a future comparative-effectiveness trial.
To evaluate key outcomes including consent rates, transfusion frequency, bleeding, and mortality.

Main Methods:

A limited-scope pilot trial randomized 30 neonates to receive platelet transfusions based on either platelet mass or platelet count.
Preset transfusion-trigger values were used for randomization.
Data collected included parental consent rate, number of transfusions, bleeding episodes, and mortality.

Main Results:

The parental consent rate was 52%.
No significant differences were observed between the platelet mass and platelet count groups in gestational age, birth weight, race, gender, or clinical diagnoses.
There were no statistically significant differences in the number of platelet transfusions, bleeding episodes, or mortality between the groups.

Conclusions:

Using platelet mass as a trigger for platelet transfusions in the NICU is feasible.
The pilot study did not show a trend towards reduced transfusion rates, indicating that a future comparative-effectiveness trial will likely require a very large sample size.
Further research is needed to confirm the efficacy and optimal sample size for platelet mass-based transfusion strategies in neonates.