Neonatal thrombocytopenia and platelet transfusions

A review article from Oxford summarizes recent evidence on thrombocytopenia and its treatment, emphasizing the lack of evidence on this topic. Approximately 25% of NICU patients develop thrombocytopenia. A pragmatic definition of neonatal thrombocytopenia is a platelet count less than 100,000 / cu mm (severe thrombocytopenia if less than 50,000 / cu mm). The cause of thrombocytopenia can be identified using commonly available algorithms. Neonates with thrombocytopenia from IUGR or maternal PIH tended to not have major hemorrhage in one study (in fact 90% of such infants with a platelet count less than 20,000 did not develop major hemorrhage). There is a small risk of viral, bacterial, or protozoal contamination of platelet transfusions. Platelet transfusion is often provided prophylactically and thresholds for transfusion vary widely between clinicians and institutions. A trial of platelet transfusions is ongoing (Planet-2).

Stanworth, 2012