Prophylactic platelet transfusion at higher thresholds was associated with increased risk of death or major bleeding in neonates

• Published in: Archives of disease in childhood. Education and practice edition Vol. 105; no. 2; pp. 127 - 128
• Main Authors: Razak, Abdul, Rahman, Ishrat
• Format: Journal Article
• Language: English
• Published: England BMJ Publishing Group LTD 01.04.2020
• Subjects: Blood; Blood platelets; Hemorrhage - mortality; Hemorrhage - prevention & control; Humans; Infant, Newborn; Infant, Premature; Infant, Premature, Diseases - mortality; Infant, Premature, Diseases - therapy; Infants; Neonates; Newborn babies; Pediatrics; Platelet Transfusion; Sepsis; Thrombocytopenia - complications; Thrombocytopenia - mortality; Thrombocytopenia - therapy; Transfusion; United States > US; haematology; neonatology
• ISSN: 1743-0585; 1743-0593
• DOI: 10.1136/archdischild-2019-316838

An international survey conducted across the USA and European countries identified significant variations in platelet-transfusion practices in preterm infants.2 Most of the platelet transfusions in preterm infants are driven by their severity of illness.3 In fact, a large proportion of preterm infants receive platelet transfusions despite the platelet count being more than 50 x109/L .3 The large, multicentre, randomised trial by Curley et al unfolds the evidence on the best practices of prophylactic platelet transfusion in preterm infants.4 The trial cohort included high-risk infants with median GA of 26.6 weeks and birth weight of 740 g which is often the case in infants with severe thrombocytopenia. [...]the results should be carefully applied in extremely preterm infants with significant thrombocytopenia in the first week of life, who mainly are at risk of intraventricular haemorrhage. [...]the outcomes of this study identify the harmful effects of prophylactic platelet transfusion practices at high threshold (less than 50 x109/L) compared with low threshold in preterm infants with significant thrombocytopenia.