The impact of platelet transfusions on bleeding in critically ill neonates with thrombocytopenia
| Reference . | N . | Population . | Study design . | Results . | Study quality* . |
|---|---|---|---|---|---|
| 20 | 1283 | VLBW neonates | Prospective observational | Institution with fewest PLT transfusions had least number of IVH cases. Infants with a greater incidence of IVH were more likely to have received PLT transfusions on days 1 and 3 (OR, 3.6; 95% CI, 1.5-8.3). | Low |
| 14 | 194 | Neonates | Prospective cohort | Major hemorrhage occurred in 40% of 31 transfused neonates (≥5 transfusions) vs 5% in 53 nontransfused neonates | Moderate |
| 22 | 168 | Neonates | Prospective observational | Twenty-one percent (95% CI, 8%-31%) reduction in minor bleeds during the 12 h period after PLT transfusion compared with 12 h before PLT transfusion | High |
| 16 | 164 | Preterm neonates | Case control (94 cases, 70 controls) | Overall 37/60 (61.7%) transfused neonates had IVH vs 7/22 (31.8%) nontransfused neonates (similar across gestational age groups) | Low |
| 8 | 152 | Preterm neonates | RCT | Major bleeding: 22/78 (28.2%) in the intervention group vs 19/74 (25.7%) in controls (PLT transfusions for platelets below 50 × 109/L); P = .73 | Low |
| 18 | 61 | Neonates | Retrospective cohort | Bleeding incidence: 60% with 1 transfusion; 42.3% with 2-4 transfusions; 35.7% with >4 transfusions | Low |
| 17 | 45 | Neonates | Retrospective cohort | Nineteen percent bleeding incidence in patients who received ≥20 PLT transfusions | Low |
| 21 | 44 | Preterm neonates | Retrospective review | No patient (25 transfused, 19 nontransfused) developed new or extended IVH | Moderate |
| 19 | NR | Neonates | Prospective cohort | Transfusion protocol based on PLT mass (PLT count × mean PLT volume) was associated with fewer grade 3 and 4 IVHs compared with a PLT-count based transfusion protocol (1.8 vs 0.4%, P = .01) | Low |
| Reference . | N . | Population . | Study design . | Results . | Study quality* . |
|---|---|---|---|---|---|
| 20 | 1283 | VLBW neonates | Prospective observational | Institution with fewest PLT transfusions had least number of IVH cases. Infants with a greater incidence of IVH were more likely to have received PLT transfusions on days 1 and 3 (OR, 3.6; 95% CI, 1.5-8.3). | Low |
| 14 | 194 | Neonates | Prospective cohort | Major hemorrhage occurred in 40% of 31 transfused neonates (≥5 transfusions) vs 5% in 53 nontransfused neonates | Moderate |
| 22 | 168 | Neonates | Prospective observational | Twenty-one percent (95% CI, 8%-31%) reduction in minor bleeds during the 12 h period after PLT transfusion compared with 12 h before PLT transfusion | High |
| 16 | 164 | Preterm neonates | Case control (94 cases, 70 controls) | Overall 37/60 (61.7%) transfused neonates had IVH vs 7/22 (31.8%) nontransfused neonates (similar across gestational age groups) | Low |
| 8 | 152 | Preterm neonates | RCT | Major bleeding: 22/78 (28.2%) in the intervention group vs 19/74 (25.7%) in controls (PLT transfusions for platelets below 50 × 109/L); P = .73 | Low |
| 18 | 61 | Neonates | Retrospective cohort | Bleeding incidence: 60% with 1 transfusion; 42.3% with 2-4 transfusions; 35.7% with >4 transfusions | Low |
| 17 | 45 | Neonates | Retrospective cohort | Nineteen percent bleeding incidence in patients who received ≥20 PLT transfusions | Low |
| 21 | 44 | Preterm neonates | Retrospective review | No patient (25 transfused, 19 nontransfused) developed new or extended IVH | Moderate |
| 19 | NR | Neonates | Prospective cohort | Transfusion protocol based on PLT mass (PLT count × mean PLT volume) was associated with fewer grade 3 and 4 IVHs compared with a PLT-count based transfusion protocol (1.8 vs 0.4%, P = .01) | Low |
VLBW, very low birth weight. Other abbreviations are explained in Table 1.
Study quality included applicability to the research question.