Related Experiment Video
Updated: May 10, 2025
Routine Screening Method for Microparticles in Platelet Transfusions
Published on: January 31, 2018
Development and implementation of restrictive platelet transfusion thresholds in a neonatal intensive care unit
Natasha Lalos1, Alexa Brumfiel2, Luke T Viehl2
1Division of Newborn Medicine, Department of Pediatrics, Washington University, St. Louis, MO, USA. nlalos@wustl.edu.
Objective:
Thrombocytopenia is a common problem affecting preterm neonates. Recent studies show increased morbidity and mortality with liberal platelet transfusion thresholds. We sought to standardize thrombocytopenia management through a transfusion guideline to reduce excessive transfusions.
Study Design:
We developed and implemented a guideline using PDSA cycles for infants with birth weights <1000 grams. Platelet transfusions were classified as indicated or non-indicated per the guideline. Severe (grade 3 or 4) intraventricular hemorrhage and pulmonary hemorrhage rates were balancing measures.
Results:
We analyzed 101 infants pre-guideline and 96 infants post-guideline. The mean monthly non-indicated transfusions significantly decreased from 13.0 to 2.0, respectively (p-value < 0.01). Incidence of severe grade IVH and pulmonary hemorrhage remained stable.
Conclusion:
Rapid implementation of an evidence-based, restrictive platelet transfusion guideline significantly reduced non-indicated platelet transfusions without a concomitant increase in major bleeding events.
More Related Videos
Related Concept Videos
01:22Formation of the Platelet Plug
As the injured blood vessel contracts, endothelial cells undergo contraction, revealing collagen fibers in the basement membrane and underlying connective tissue. Furthermore, the plasma membrane of endothelial cells becomes adhesive, preparing the site for platelet adhesion. Platelets...
02:45Blood Transfusion and Agglutination
History
The history of blood transfusion dates back to the 17th century, when early attempts were made in animals. In 1818 James Blundell, a British doctor, performed the first successful human blood transfusion. Later in 1900, Karl...