Efficacy of Platelet Transfusion in Thrombocytopenia Due to Gram-Negative Late-Onset Neonatal Sepsis

Purpose: We aimed to determine the effectiveness of platelet transfusions in the presence of thrombocytopenia in late-onset neonatal sepsis (LONS) caused by gram-negative bacteria in preterm neonates. Methods: The newborns, who received platelet transfusions, were divided into two groups: those with bleeding and those without bleeding. Results: The median gestational age and birth weight of the newborns were 29 (26-31) w and 1100 (865-1470) g, respectively. Of the 72 neonates, 50 (69.5%) did not bleed and 22 (30.5%) bled. The time for the platelet count to exceed 50,000/µL was similar between the groups: 5 (3-10) days in the bleeding group and 4 (3-7) days in the non-bleeding group, and the median number of transfusions was two in both groups. In the transfused group, the mortality rate in patients with bleeding was significantly higher compared to those without bleeding (27.3% vs. 8%, p = 0.0001). Conclusion: Although platelet transfusion was performed in the presence of severe thrombocytopenia in gram-negative LONS, the platelet counts exceeded 50,000/µL not immediately after transfusion, but in approximately four days, and repeated platelet transfusions were generally required. The mortality rate was higher in those who bled compared to those who did not bleed.

The online version contains supplementary material available at 10.1007/s12288-024-01916-6.