Platelet transfusions in the neonatal intensive care unit

Factors predicting which patients will require multiple transfusions

Antonio Del Vecchio, Martha C. Sola, Douglas W. Theriaque, Alan D. Hutson, K. J. Kao, Dale Wright, Maria G. Garcia, Bradley H Pollock, Robert D. Christensen

Research output: Contribution to journalArticle

80 Citations (Scopus)

Abstract

BACKGROUND: Previous studies suggest that recombinant thrombopoietin (rTPO) will increase platelet production in thrombocytopenic neonates. However, the target populations of neonates most likely to benefit should be defined. Studies suggest that rTPO will not elevate the platelet count until 5 days after the start of treatment. Therefore, the neonates who might benefit from rTPO are those who will require multiple platelet transfusions for more than 5 days. This study was designed to find means of prospectively identifying these patients. STUDY DESIGN AND METHODS: A historic cohort study of all patients in the neonatal intensive care unit (NICU) at the University of Florida who received platelet transfusions from January 1, 1997, through December 31, 1998, was conducted. RESULTS: Of the 1389 patients admitted to the NICU during the study period, 131 (9.4%) received platelet transfusions. Seventeen were treated with extracorporeal membrane oxygenation and were excluded from further analysis. Of the remaining 114 patients, 55 (48%) received one transfusion and 59 (52%) received more than one transfusion (21 had >4). None of the demographic factors examined predicted multiple platelet transfusions. However, two clinical conditions did; liver disease and renal insufficiency. Neonates who received one platelet transfusion had a relative risk of death 10.4 times that in neonates who received none (p = 0.0001). Neonates who received >4 platelet transfusions had a risk of death 29.9 times that in those who received no transfusions (p = 0.0001). CONCLUSION: NICU patients with liver disease or renal insufficiency who receive one platelet transfusion are likely to receive additional transfusions. Therefore, these patients constitute a possible study population for a Phase I/II rTPO trial.

Original languageEnglish (US)
Pages (from-to)803-808
Number of pages6
JournalTransfusion
Volume41
Issue number6
DOIs
StatePublished - 2001
Externally publishedYes

Fingerprint

Platelet Transfusion
Neonatal Intensive Care Units
Thrombopoietin
Newborn Infant
Hepatic Insufficiency
Renal Insufficiency
Liver Diseases
Extracorporeal Membrane Oxygenation
Health Services Needs and Demand
Platelet Count
Cohort Studies
Blood Platelets
Demography
Population

ASJC Scopus subject areas

  • Hematology
  • Immunology

Cite this

Del Vecchio, A., Sola, M. C., Theriaque, D. W., Hutson, A. D., Kao, K. J., Wright, D., ... Christensen, R. D. (2001). Platelet transfusions in the neonatal intensive care unit: Factors predicting which patients will require multiple transfusions. Transfusion, 41(6), 803-808. https://doi.org/10.1046/j.1537-2995.2001.41060803.x

Platelet transfusions in the neonatal intensive care unit : Factors predicting which patients will require multiple transfusions. / Del Vecchio, Antonio; Sola, Martha C.; Theriaque, Douglas W.; Hutson, Alan D.; Kao, K. J.; Wright, Dale; Garcia, Maria G.; Pollock, Bradley H; Christensen, Robert D.

In: Transfusion, Vol. 41, No. 6, 2001, p. 803-808.

Research output: Contribution to journalArticle

Del Vecchio, A, Sola, MC, Theriaque, DW, Hutson, AD, Kao, KJ, Wright, D, Garcia, MG, Pollock, BH & Christensen, RD 2001, 'Platelet transfusions in the neonatal intensive care unit: Factors predicting which patients will require multiple transfusions', Transfusion, vol. 41, no. 6, pp. 803-808. https://doi.org/10.1046/j.1537-2995.2001.41060803.x
Del Vecchio, Antonio ; Sola, Martha C. ; Theriaque, Douglas W. ; Hutson, Alan D. ; Kao, K. J. ; Wright, Dale ; Garcia, Maria G. ; Pollock, Bradley H ; Christensen, Robert D. / Platelet transfusions in the neonatal intensive care unit : Factors predicting which patients will require multiple transfusions. In: Transfusion. 2001 ; Vol. 41, No. 6. pp. 803-808.
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abstract = "BACKGROUND: Previous studies suggest that recombinant thrombopoietin (rTPO) will increase platelet production in thrombocytopenic neonates. However, the target populations of neonates most likely to benefit should be defined. Studies suggest that rTPO will not elevate the platelet count until 5 days after the start of treatment. Therefore, the neonates who might benefit from rTPO are those who will require multiple platelet transfusions for more than 5 days. This study was designed to find means of prospectively identifying these patients. STUDY DESIGN AND METHODS: A historic cohort study of all patients in the neonatal intensive care unit (NICU) at the University of Florida who received platelet transfusions from January 1, 1997, through December 31, 1998, was conducted. RESULTS: Of the 1389 patients admitted to the NICU during the study period, 131 (9.4{\%}) received platelet transfusions. Seventeen were treated with extracorporeal membrane oxygenation and were excluded from further analysis. Of the remaining 114 patients, 55 (48{\%}) received one transfusion and 59 (52{\%}) received more than one transfusion (21 had >4). None of the demographic factors examined predicted multiple platelet transfusions. However, two clinical conditions did; liver disease and renal insufficiency. Neonates who received one platelet transfusion had a relative risk of death 10.4 times that in neonates who received none (p = 0.0001). Neonates who received >4 platelet transfusions had a risk of death 29.9 times that in those who received no transfusions (p = 0.0001). CONCLUSION: NICU patients with liver disease or renal insufficiency who receive one platelet transfusion are likely to receive additional transfusions. Therefore, these patients constitute a possible study population for a Phase I/II rTPO trial.",
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AU - Del Vecchio, Antonio

AU - Sola, Martha C.

AU - Theriaque, Douglas W.

AU - Hutson, Alan D.

AU - Kao, K. J.

AU - Wright, Dale

AU - Garcia, Maria G.

AU - Pollock, Bradley H

AU - Christensen, Robert D.

PY - 2001

Y1 - 2001

N2 - BACKGROUND: Previous studies suggest that recombinant thrombopoietin (rTPO) will increase platelet production in thrombocytopenic neonates. However, the target populations of neonates most likely to benefit should be defined. Studies suggest that rTPO will not elevate the platelet count until 5 days after the start of treatment. Therefore, the neonates who might benefit from rTPO are those who will require multiple platelet transfusions for more than 5 days. This study was designed to find means of prospectively identifying these patients. STUDY DESIGN AND METHODS: A historic cohort study of all patients in the neonatal intensive care unit (NICU) at the University of Florida who received platelet transfusions from January 1, 1997, through December 31, 1998, was conducted. RESULTS: Of the 1389 patients admitted to the NICU during the study period, 131 (9.4%) received platelet transfusions. Seventeen were treated with extracorporeal membrane oxygenation and were excluded from further analysis. Of the remaining 114 patients, 55 (48%) received one transfusion and 59 (52%) received more than one transfusion (21 had >4). None of the demographic factors examined predicted multiple platelet transfusions. However, two clinical conditions did; liver disease and renal insufficiency. Neonates who received one platelet transfusion had a relative risk of death 10.4 times that in neonates who received none (p = 0.0001). Neonates who received >4 platelet transfusions had a risk of death 29.9 times that in those who received no transfusions (p = 0.0001). CONCLUSION: NICU patients with liver disease or renal insufficiency who receive one platelet transfusion are likely to receive additional transfusions. Therefore, these patients constitute a possible study population for a Phase I/II rTPO trial.

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